MEDICARE: DR. WILLIAM CHARLES HEALEY DPM

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	213E00000X	Podiatrist	NC 104	NC

General Provider Information

NPI Number	:	1487681607
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM CHARLES HEALEY DPM

Provider Business Mailing Address
First Line	:	2817 REILLY ROAD
Second Line	:	WOMACK ARMY MEDICAL CENTER MCXC-COD CREDENTIALS
City	:	FORT BRAGG
State	:	NC
Zip	:	28310
Country	:	US
Telephone Number	:	910-907-8922
Fax Number	:	910-907-6069

Provider Business Practice Location Address
First Line	:	2817 REILLY RD WOMACK ARMY MEDICAL CENTER
Second Line	:	DEPT OF ORTHOPAEDICS
City	:	FORT BRAGG
State	:	NC
Zip	:	28310-5000
Country	:	US
Telephone Number	:	910-907-7749
Fax Number	:	910-907-7623

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

Provider Enumeration Date	:	06/26/2006
Last Update Date	:	07/08/2007

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