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NPI Code Detail

MEDICARE: DR. WILLIAM HANES MCCUSKEY M.D.

MEDICARE: DR. WILLIAM HANES MCCUSKEY 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 PhysicianME103541FL
2174400000XSpecialist34395NC
32085R0202XDiagnostic Radiology Physician34395NC
42085R0202XDiagnostic Radiology Physician0101245169VA

Other Identifiers

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

General Provider Information

NPI Number : 1902803562
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WILLIAM HANES MCCUSKEY M.D.
Provider Business Mailing Address
First Line : 3660 BROADWAY
Second Line :
City : FORT MYERS
State : FL
Zip : 33901-8005
Country : US
Telephone Number : 239-936-2316
Fax Number : 239-834-6106
Provider Business Practice Location Address
First Line : 3680 BROADWAY
Second Line :
City : FORT MYERS
State : FL
Zip : 33901-8005
Country : US
Telephone Number : 239-936-2316
Fax Number : 239-834-6106
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2005
Last Update Date : 12/20/2023

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