Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | ME113337 | FL |
NPI | 1013229368 |
---|---|
Provider Name | Dr. William Lee Titsworth |
First Address | Paducah, KY 42003-3800 |
Second Address | Paducah, KY 42003-3814 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2010 |
Last Update Date | 04/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
018511900 | (05) | FL |