Provider Demographics
NPI:1821294588
Name:PEERY, WILLIAM ROSS II (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:ROSS
Last Name:PEERY
Suffix:II
Gender:M
Credentials:MD
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Mailing Address - Street 1:6920 POINTE INVERNESS WAY STE 200
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46804-7934
Mailing Address - Country:US
Mailing Address - Phone:260-479-3514
Mailing Address - Fax:260-479-3520
Practice Address - Street 1:7900 W JEFFERSON BLVD STE 306
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46804-4128
Practice Address - Country:US
Practice Address - Phone:260-458-3610
Practice Address - Fax:260-458-3611
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2024-08-14
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Provider Licenses
StateLicense IDTaxonomies
IN01080921A2086S0102X
GA850562086S0127X
WV241312086S0127X, 2086S0127X, 208600000X
KY46280208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810020938Medicaid
KY7100280780Medicaid
KY7100280780Medicaid
WVWV0492AMedicare UPIN