MEDICARE: DR. WILLIAM D. SCHENK

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	207W00000X	Ophthalmology Physician	16211	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	180003265	OTHER	TN	PALMETTO GBA
2	000047586	OTHER	TN	BLUE CROSS BLUE SHIELD
3	3013671	OTHER	TN	HEALTHSPRING
4	000047586	OTHER	TN	TENNCARE SELECT
5	1238610001	OTHER	TN	DMERC
6	000047586	OTHER	TN	BCBS ADVANTAGE
7	3180072	OTHER	TN	CIGNA
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	4065477	OTHER	TN	AETNA PPO
10	621298175	OTHER	TN	DEFAULT

General Provider Information

NPI Number	:	1306847009
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM D. SCHENK

Provider Business Mailing Address
First Line	:	1670 W MAIN ST
Second Line	:	STE100
City	:	LEBANON
State	:	TN
Zip	:	37087-1344
Country	:	US
Telephone Number	:	615-444-4516
Fax Number	:

Provider Business Practice Location Address
First Line	:	1670 W MAIN ST
Second Line	:	STE 100
City	:	LEBANON
State	:	TN
Zip	:	37087-1344
Country	:	US
Telephone Number	:	615-453-5155
Fax Number	:	615-444-5915

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

Provider Enumeration Date	:	08/03/2005
Last Update Date	:	02/02/2009

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Directions to “ DR. WILLIAM D. SCHENK ” Practice Location

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