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NPI Code Detail

MEDICARE: WILLIAM F. PROCTOR M.D.

MEDICARE: WILLIAM F. PROCTOR M.D.
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
12085R0202XDiagnostic Radiology Physician94-01305NC
22085R0202XDiagnostic Radiology Physician28513SC

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00773321OTHERSCRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID 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 : 1356340475
Entity Type Code : Individual
Provider Name (Legal Business Name) : WILLIAM F. PROCTOR M.D.
Provider Business Mailing Address
First Line : PO BOX 2363
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46206-2363
Country : US
Telephone Number : 843-724-2988
Fax Number : 843-805-6277
Provider Business Practice Location Address
First Line : 316 CALHOUN ST
Second Line :
City : CHARLESTON
State : SC
Zip : 29401-1113
Country : US
Telephone Number : 843-724-2988
Fax Number : 843-805-6277
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2005
Last Update Date : 02/14/2014

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Directions to “ WILLIAM F. PROCTOR M.D.” Practice Location

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