Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 30731 | NC |
NPI | 1003862574 |
---|---|
Provider Name | Dr. William T Sither |
First Address | Bardstown, KY 40004-2536 |
Second Address | Bardstown, KY 40004-9019 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2006 |
Last Update Date | 30/08/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
132U6 | BCBS (01) | NC |
89132U6 | (05) | NC |
C86476 | (02) | |
Q30731 | (05) | SC |