Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | ME0050306 | FL |
NPI | 1013941301 |
---|---|
Provider Name | William W Dent |
First Address | Panama City, FL 32401-3661 |
Second Address | Panama City, FL 32401-3661 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2006 |
Last Update Date | 19/09/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D50691 | (02) | FL |
K7890 | MEDICARE (01) | FL |