Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | ME89370 | FL |
NPI | 1437595675 |
---|---|
Provider Name | Dr. William Thomas Stillwell |
First Address | Lake Mary, FL 32746-2012 |
Second Address | Lake Mary, FL 32746-2012 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2013 |
Last Update Date | 15/05/2013 |