MEDICARE: DR. WILLIAM NORMAN GINN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	35-046499	OH

General Provider Information

NPI Number	:	1003907585
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM NORMAN GINN M.D.

Provider Business Mailing Address
First Line	:	5289 KESSLER FREDERICK RD
Second Line	:
City	:	TROY
State	:	OH
Zip	:	45373-9551
Country	:	US
Telephone Number	:	937-698-6344
Fax Number	:	937-698-6675

Provider Business Practice Location Address
First Line	:	751 S MIAMI ST
Second Line	:
City	:	WEST MILTON
State	:	OH
Zip	:	45383-1303
Country	:	US
Telephone Number	:	937-698-4158
Fax Number	:	937-698-6675

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2006
Last Update Date	:	12/18/2007

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