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General NPI Number Information
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NPI Number | 1972700342
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Entity Type | Organization
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Legal Business Name | WILLIAM A. SCHWANK, M.D.
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Dates
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Enumeration Date | 06/29/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1890 LYDA AVE STE 101
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City | BOWLING GREEN
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State | KY
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Zip | 42104-5829
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Country | US
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Telephone | 270-782-3103
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Fax |
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Provider Business Mailing Address
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Address Line | 1890 LYDA AVE
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City | BOWLING GREEN
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State | KY
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Zip | 42104-5829
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Country | US
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Telephone | 270-782-3103
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Fax |
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Authorized Official
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Title or Position | AR MANAGER
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Name | ASHLIE MOSLEY
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Credential |
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Telephone | 270-782-3103
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 18796
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License Number State | KY
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