1588667638 NPI number — DR. WILLIAM C PILCHER MD

Employer Identification Number (EIN)	:
Provider Organization Name (Legal Business Name)	:
Provider Last Name (Legal Name)	:	PILCHER
Provider First Name	:	WILLIAM
Provider Middle Name	:	C
Provider Name Prefix Text	:	DR.
Provider Name Suffix Text	:
Provider Credential Text	:	MD
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	:	1588667638
Entity Type Code	:	Individual
Replacement NPI	:
Last Update Date	:	09/29/2008
NPI Deactivation Reason Code	:
NPI Deactivation Date	:
NPI Reactivation Date	:

Provider First Line Business Mailing Address	:	562 PARK ST
Provider Second Line Business Mailing Address	:	STE 310
Provider Business Mailing Address City Name	:	JACKSONVILLE
Provider Business Mailing Address State Name	:	FL
Provider Business Mailing Address Postal Code	:	322042962
Provider Business Mailing Address Country Code	:	US
Provider Business Mailing Address Telephone Number	:	9046332021
Provider Business Mailing Address Fax Number	:	9046339793

Provider First Line Business Practice Location Address	:	1824 KING ST
Provider Second Line Business Practice Location Address	:	SUITE 300
Provider Business Practice Location Address City Name	:	JACKSONVILLE
Provider Business Practice Location Address State Name	:	FL
Provider Business Practice Location Address Postal Code	:	322044735
Provider Business Practice Location Address Country Code	:	US
Provider Business Practice Location Address Telephone Number	:	9043881820
Provider Business Practice Location Address Fax Number	:	9043881827
Provider Enumeration Date	:	05/23/2005

Authorized Official Last Name	:
Authorized Official First Name	:
Authorized Official Middle Name	:
Authorized Official Title or Position	:
Authorized Official Telephone Number	:

• Taxonomy code: 207RC0000X , with the licence number:  032024 , registered in the state of GA .
• Taxonomy code: 207RC0000X , with the licence number: ME68414 , registered in the state of FL .

• Identifier: 110123591 . This is a "RAILROAD MCARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "".
• Identifier: 510265 . This is a "BCBS" identifier , issued by the state of ( GA ) . This identifiers is of the category "".
• Identifier: 251286600 , issued by the state of ( FL ) . This identifiers is of the category "".
• Identifier: 0897705 . This is a "AETNA" identifier , issued by the state of ( FL ) . This identifiers is of the category "".
• Identifier: 27888 . This is a "BCBS" identifier , issued by the state of ( FL ) . This identifiers is of the category "".
• Identifier: C73899 , issued by the state of ( FL ) . This identifiers is of the category "".
• Identifier: 208143 . This is a "AVMED" identifier , issued by the state of ( FL ) . This identifiers is of the category "".
• Identifier: 00706626A , issued by the state of ( GA ) . This identifiers is of the category "".
• Identifier: 27888Z , issued by the state of ( FL ) . This identifiers is of the category "".
• Identifier: 00532485C , issued by the state of ( GA ) . This identifiers is of the category "".
• Identifier: 06BDGPK , issued by the state of ( GA ) . This identifiers is of the category "".