MEDICARE: DR. WILLIAM ALAN MISCHLER D.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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	4963	KY

General Provider Information

NPI Number	:	1881700680
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM ALAN MISCHLER D.M.D

Provider Business Mailing Address
First Line	:	4602 SOUTHERN PKWY 2D
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40214-1442
Country	:	US
Telephone Number	:	502-368-2513
Fax Number	:

Provider Business Practice Location Address
First Line	:	4602 SOUTHERN PKWY
Second Line	:	2D
City	:	LOUISVILLE
State	:	KY
Zip	:	40214-1442
Country	:	US
Telephone Number	:	502-368-2513
Fax Number	:

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

Provider Enumeration Date	:	08/22/2006
Last Update Date	:	06/10/2014

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