Healthcare Provider Details

I. General information

NPI: 1528103553
Provider Name (Legal Business Name): WILLIAM TODD OVERCASH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/20/2007
Last Update Date: 04/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6035 SW 54TH ST SUITE 200
OCALA FL
34474-5519
US

IV. Provider business mailing address

6035 SW 54TH ST SUITE 200
OCALA FL
34474-5519
US

V. Phone/Fax

Practice location:
  • Phone: 352-671-1830
  • Fax: 352-433-0220
Mailing address:
  • Phone: 352-671-1830
  • Fax: 352-433-0220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberME56492
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberME56492
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License NumberME56492
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME56492
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: