Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | - | KY |
N | 222Z00000X | Podiatrist | - | KY |
Y | 213E00000X | Podiatrist | 07001357 | IN |
Y | 222Z00000X | Podiatrist | 07001357 | IN |
N | 213ES0103X | Foot & Ankle Surgery | 07001357 | IN |
NPI | 1053801019 |
---|---|
Provider Name | Dr. William Ottis Mcglone III |
First Address | Carmel, IN 46032-4900 |
Second Address | Carmel, IN 46032-4900 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2018 |
Last Update Date | 25/06/2021 |