Healthcare Provider Details

I. General information

NPI: 1780705194
Provider Name (Legal Business Name): WILLIAM THEOTIS GHEE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 06/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3525 LAKELAND HILLS BLVD
LAKELAND FL
33805-1965
US

IV. Provider business mailing address

PO BOX 102101
ATLANTA GA
30368-2101
US

V. Phone/Fax

Practice location:
  • Phone: 863-603-6565
  • Fax: 863-603-6576
Mailing address:
  • Phone: 863-603-6565
  • Fax: 863-603-6576

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberD0051628
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: