1891750550 NPI number — DR. WILLIAM ORLON SHAFFER M.D.

Table of content: DR. WILLIAM ORLON SHAFFER M.D. (NPI 1891750550)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891750550 NPI number — DR. WILLIAM ORLON SHAFFER M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SHAFFER
Provider First Name:
WILLIAM
Provider Middle Name:
ORLON
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

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 Information

NPI Number:
1891750550
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/28/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1200 1ST AVE E STE C
Provider Second Line Business Mailing Address:
NORTHWEST IOWA BONE JOINT & SPORTS SURGEONS
Provider Business Mailing Address City Name:
SPENCER
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
51301-4342
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
712-262-7511
Provider Business Mailing Address Fax Number:
712-262-3658

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
740 S. LIMESTONE STREET
Provider Second Line Business Practice Location Address:
K-416 KENTUCKY CLINIC
Provider Business Practice Location Address City Name:
LEXINGTON
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40536-0284
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-323-5533
Provider Business Practice Location Address Fax Number:
859-323-2412
Provider Enumeration Date:
04/18/2006

Additional Information

Authorized Official

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

Provider Taxonomy Codes

  • Taxonomy code: 207X00000X , with the licence number:  36600 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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