Provider Demographics
NPI:1912990953
Name:BANKS, WILLIAM R II (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:R
Last Name:BANKS
Suffix:II
Gender:M
Credentials:MD
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Mailing Address - Street 1:5200 COMMERCE CROSSINGS DR FL 3
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40229-2182
Mailing Address - Country:US
Mailing Address - Phone:502-253-4977
Mailing Address - Fax:502-489-5751
Practice Address - Street 1:2108 NICHOLASVILLE RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-2502
Practice Address - Country:US
Practice Address - Phone:859-278-9413
Practice Address - Fax:859-276-0715
Is Sole Proprietor?:No
Enumeration Date:2005-08-24
Last Update Date:2020-02-04
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Provider Licenses
StateLicense IDTaxonomies
KY34789207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY0400997OtherUNITED HEALTHCARE
KY110224279OtherRAILROAD MEDICARE
KY611012421YOtherHUMANA
KY0000000200356OtherANTHEM BLUE SHIELD
KY611012421OtherTPN CONTRACTS
KY611012421004OtherTRICARE CHAMPUS
KY611012421OtherAETNA
KYH19626OtherBLUEGRASS HMO
KY0037675OtherMEDICARE - FAYETTE COUNTY HEALTH DEPARTMENT
KY64-018013Medicaid
KY0076511Medicare ID - Type UnspecifiedMEDICARE
KY0037675OtherMEDICARE - FAYETTE COUNTY HEALTH DEPARTMENT
KY110224279OtherRAILROAD MEDICARE