Provider Demographics
NPI:1902074503
Name:SANCHEZ, WILLIAM RAFAEL (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:RAFAEL
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 E NEW CIRCLE RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40505-2619
Mailing Address - Country:US
Mailing Address - Phone:859-523-3797
Mailing Address - Fax:859-523-3948
Practice Address - Street 1:450 E NEW CIRCLE RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40505-2619
Practice Address - Country:US
Practice Address - Phone:859-523-3797
Practice Address - Fax:859-523-3948
Is Sole Proprietor?:No
Enumeration Date:2008-02-15
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAU-2903599-9914208600000X
KY42437207Q00000X, 207P00000X
CT050155208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1902074503OtherBCBS KY
TN4220249OtherTN BCBS
KY7100072140Medicaid
KY7100072140Medicaid