Healthcare Provider Details
I. General information
NPI: 1568442812
Provider Name (Legal Business Name): WILLIAM H WARRICK III MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/20/2006
Last Update Date: 12/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4343 W NEWBERRY RD SUITE 11
GAINESVILLE FL
32607-2817
US
IV. Provider business mailing address
4881 NW 8TH AVE SUITE 2
GAINESVILLE FL
32605-4582
US
V. Phone/Fax
- Phone: 352-372-3471
- Fax: 352-375-2442
- Phone: 352-373-6338
- Fax: 352-373-6144
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | ME35673 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: