1124018908 NPI number — BILL ATKINSON M.D.

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124018908 NPI number — BILL ATKINSON M.D.

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

ATKINSON

Provider First Name:

BILL

Provider Middle Name:

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

M.D.

Provider Gender Code:

M

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1124018908

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

03/07/2023

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

4904 116TH ST

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

LUBBOCK

Provider Business Mailing Address State Name:

TX

Provider Business Mailing Address Postal Code:

79424-7600

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

806-441-9529

Provider Business Mailing Address Fax Number:

806-723-6532

Provider First Line Business Practice Location Address:

4102 24TH ST

Provider Second Line Business Practice Location Address:

STE 300

Provider Business Practice Location Address City Name:

LUBBOCK

Provider Business Practice Location Address State Name:

TX

Provider Business Practice Location Address Postal Code:

79410-1806

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

806-725-5497

Provider Business Practice Location Address Fax Number:

806-723-6299

Provider Enumeration Date:

10/24/2005

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 207VM0101X , with the licence number:  G3121 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 36807 . This is a "PRESBYTERIAN COMMERCIAL" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
• Identifier: 36807 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".
• Identifier: 100150770A , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".
• Identifier: 128708806 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
• Identifier: 128708807 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
• Identifier: X6909 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".
• Identifier: 80832Z . This is a "HMO BLUE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
• Identifier: 100108103 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
• Identifier: A598 . This is a "TRIWEST" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
• Identifier: 83G030 . This is a "BC/BS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
• Identifier: 100108102 . This is a "FIRSTCARE COMMERCIAL" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
• Identifier: 128708803 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
• Identifier: 60061447 . This is a "DPS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".