MEDICARE: WILLIAM M DUCEY 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
1	208600000X	Surgery Physician	01035874	IN
2	2086S0129X	Vascular Surgery Physician	01035874	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	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
3	000000704985	OTHER	ANTHEM

General Provider Information

NPI Number	:	1891790176
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM M DUCEY M.D.

Provider Business Mailing Address
First Line	:	1100 REID PKWY
Second Line	:	MEDICAL STAFFF SERVICES
City	:	RICHMOND
State	:	IN
Zip	:	47374-1157
Country	:	US
Telephone Number	:	765-939-9331
Fax Number	:	765-939-9314

Provider Business Practice Location Address
First Line	:	1100 REID PKWY
Second Line	:	SUITE 215
City	:	RICHMOND
State	:	IN
Zip	:	47374-1157
Country	:	US
Telephone Number	:	765-939-9331
Fax Number	:	765-939-9314

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

Provider Enumeration Date	:	06/14/2005
Last Update Date	:	01/12/2015

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Directions to “ WILLIAM M DUCEY M.D.” Practice Location

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