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NPI Code Detail

MEDICARE: WILLIAM L INGRAM III MD

MEDICARE: WILLIAM L INGRAM III MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician35404IA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
239643OTHERIAWELLMARK BC/BS
3110983OTHERHEALTH ALLIANCE
4IA01B6OTHERJOHN DEERE HEALTH
5242932OTHERMIDLANDS CHOICE

General Provider Information

NPI Number : 1013996636
Entity Type Code : Individual
Provider Name (Legal Business Name) : WILLIAM L INGRAM III MD
Provider Business Mailing Address
First Line : 915 13TH AVE N
Second Line :
City : CLINTON
State : IA
Zip : 52732-5067
Country : US
Telephone Number : 563-243-2511
Fax Number : 563-243-0817
Provider Business Practice Location Address
First Line : 915 13TH AVE N
Second Line :
City : CLINTON
State : IA
Zip : 52732-5067
Country : US
Telephone Number : 563-243-2511
Fax Number : 563-243-0817
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/12/2006
Last Update Date : 03/15/2013

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Directions to “ WILLIAM L INGRAM III MD” Practice Location

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