Healthcare Provider Details

I. General information

NPI: 1740469105
Provider Name (Legal Business Name): WILLIAM T. ESHAM, M.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2007
Last Update Date: 11/01/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1611 27TH ST BLDG J STE. 102
PORTSMOUTH OH
45662-6931
US

IV. Provider business mailing address

1611 27TH ST BLDG J STE. 102
PORTSMOUTH OH
45662-6931
US

V. Phone/Fax

Practice location:
  • Phone: 740-353-3189
  • Fax: 740-353-7672
Mailing address:
  • Phone: 740-353-3189
  • Fax: 740-353-7672

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM THURN ESHAM
Title or Position: MEDICAL PHYSICIAN
Credential: M.D
Phone: 740-353-3189