1972589810 NPI number — DR. WILLIAM J DUGGAN DO

Table of content: DR. WILLIAM J DUGGAN DO (NPI 1972589810)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972589810 NPI number — DR. WILLIAM J DUGGAN DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DUGGAN
Provider First Name:
WILLIAM
Provider Middle Name:
J
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DO
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DUGGAN
Provider Other First Name:
LIAM
Provider Other Middle Name:
J
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
DO
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1972589810
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/13/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10571 FALLS CREEK LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CENTERVILLE
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45458-6006
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
937-885-1750
Provider Business Mailing Address Fax Number:
937-885-1751

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10571 FALLS CREEK LN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CENTERVILLE
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45458-6006
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
937-885-1750
Provider Business Practice Location Address Fax Number:
937-885-1751
Provider Enumeration Date:
12/22/2005

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: 207V00000X , with the licence number:  34003999 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0720167 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: D0399911 . This is a "HUMANA/CHOICECARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 0694481 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 160058958 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 000000227866 . This is a "ANTHEM" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 000000227866 . This is a "UNICARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 34003999D . This is a "MEDICAL LICENSE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: D0399910 . This is a "HUMANA/CHOICECARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 421534506060 . This is a "CARESOURCE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: OC018842 . This is a "NATIONWIDE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 2916334 . This is a "AETNA" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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