MEDICARE: DR. WILLIAM ARDREY 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	207P00000X	Emergency Medicine Physician	22174	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134171630
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM ARDREY M.D.

Provider Business Mailing Address
First Line	:	833 ALBEMARLE DR
Second Line	:
City	:	BOWLING GREEN
State	:	KY
Zip	:	42103-1573
Country	:	US
Telephone Number	:	502-339-8000
Fax Number	:

Provider Business Practice Location Address
First Line	:	723 BURKESVILLE RD
Second Line	:
City	:	ALBANY
State	:	KY
Zip	:	42602-1654
Country	:	US
Telephone Number	:	606-387-7090
Fax Number	:

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

Provider Enumeration Date	:	05/16/2006
Last Update Date	:	03/20/2009

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