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General NPI Number Information
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NPI Number | 1013122167
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Entity Type | Organization
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Legal Business Name | WILLIAM J. HANSHAW, M.D., P.C.
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Dates
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Enumeration Date | 05/11/2007
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Last Update Date | 01/18/2008
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Provider Practice Location Address
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Address Line | 903 VERMONT ST
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City | QUINCY
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State | IL
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Zip | 62301-3049
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Country | US
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Telephone | 217-228-0090
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Fax | 217-228-9464
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Provider Business Mailing Address
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Address Line | 903 VERMONT ST
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City | QUINCY
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State | IL
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Zip | 62301-3049
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Country | US
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Telephone | 217-228-0090
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Fax | 217-228-9464
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. WILLIAM J HANSHAW
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Credential | M.D.
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Telephone | 217-228-0090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State | IL
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