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NPI Code Detail

MEDICARE: DR. WILLIAM A HILGENDORF PHD

MEDICARE: DR. WILLIAM A HILGENDORF PHD
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
1103T00000XPsychologist20040359AIN
2103TC0700XClinical Psychologist20040359AIN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00831908OTHERINRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1265439921
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WILLIAM A HILGENDORF PHD
Provider Business Mailing Address
First Line : 250 N SHADELAND AVE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46219-4959
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 11725 N ILLINOIS ST
Second Line : STE 3501
City : CARMEL
State : IN
Zip : 46032-3008
Country : US
Telephone Number : 317-688-2647
Fax Number : 317-688-2921
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2005
Last Update Date : 10/19/2021

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