Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 301 | NC |
Y | 222Z00000X | Podiatrist | 301 | NC |
N | 213EP1101X | Primary Podiatric Medicine | 301 | NC |
N | 213ES0103X | Foot & Ankle Surgery | 301 | NC |
N | 213ES0131X | Foot Surgery | 301 | NC |
NPI | 1417943887 |
---|---|
Provider Name | William D Banks |
First Address | Clyde, NC 28721-0278 |
Second Address | Waynesville, NC 28785-9006 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2005 |
Last Update Date | 09/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0801K | BCBS (01) | NC |
890801K | (05) | NC |
U13002 | (02) |