Healthcare Provider Details

I. General information

NPI: 1831194554
Provider Name (Legal Business Name): WILLIAM BAXTER PIERCE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/17/2005
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

229 SUMMIT ST STE 8
BATAVIA NY
14020-1645
US

IV. Provider business mailing address

229 SUMMIT ST STE 8
BATAVIA NY
14020-1645
US

V. Phone/Fax

Practice location:
  • Phone: 585-344-0007
  • Fax: 585-344-0186
Mailing address:
  • Phone: 585-344-0007
  • Fax: 585-344-0186

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0602X
TaxonomyOtolaryngic Allergy Physician
License Number114504
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: