Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | OS14595 | FL |
NPI | 1013957240 |
---|---|
Provider Name | Dr. William F Stiles III |
First Address | Fort Walton Beach, FL 32547 |
Second Address | Fort Walton Beach, FL 32547 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2006 |
Last Update Date | 04/06/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
777193 | (05) | AZ |