Healthcare Provider Details

I. General information

NPI: 1134395650
Provider Name (Legal Business Name): WILLIAM EDWIN MCGRADY II M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2008
Last Update Date: 05/28/2025
Certification Date: 05/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 SAINT CLAIR ST
FRANKFORT KY
40601-1817
US

IV. Provider business mailing address

208 LONG BRANCH LN
LEXINGTON KY
40511-8832
US

V. Phone/Fax

Practice location:
  • Phone: 502-227-4216
  • Fax: 502-227-4529
Mailing address:
  • Phone: 132-599-7017
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberBP1-0031952
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number54287
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: