MEDICARE: DR. WILLIAM HAMILTON THETFORD DPM

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
1	213ES0103X	Foot & Ankle Surgery Podiatrist	DPM785	TN
2	213ES0103X	Foot & Ankle Surgery Podiatrist	PO3911	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1497983241
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM HAMILTON THETFORD DPM

Provider Business Mailing Address
First Line	:	2540 WINKLER AVE
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33901-9338
Country	:	US
Telephone Number	:	239-278-4100
Fax Number	:	239-278-3907

Provider Business Practice Location Address
First Line	:	2540 WINKLER AVE
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33901-9338
Country	:	US
Telephone Number	:	239-278-4100
Fax Number	:	239-278-3907

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2009
Last Update Date	:	11/14/2023

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