Healthcare Provider Details

I. General information

NPI: 1417943887
Provider Name (Legal Business Name): WILLIAM D BANKS DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2005
Last Update Date: 07/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

289 ACCESS RD
WAYNESVILLE NC
28785-9006
US

IV. Provider business mailing address

PO BOX 278
CLYDE NC
28721-0278
US

V. Phone/Fax

Practice location:
  • Phone: 828-452-4343
  • Fax: 828-452-1477
Mailing address:
  • Phone: 828-452-4343
  • Fax: 828-452-1477

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number301
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License Number301
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number301
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number301
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: