Provider Demographics
NPI:1649333543
Name:ESHAM, WILLIAM THURN (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:THURN
Last Name:ESHAM
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 1:1611 27TH ST
Mailing Address - Street 2:BLDG. J, SUITE 102
Mailing Address - City:PORTSMOUTH
Mailing Address - State:OH
Mailing Address - Zip Code:45662-6931
Mailing Address - Country:US
Mailing Address - Phone:740-353-3189
Mailing Address - Fax:740-353-7672
Practice Address - Street 1:1611 27TH ST
Practice Address - Street 2:BLDG. J, SUITE 102
Practice Address - City:PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45662-6931
Practice Address - Country:US
Practice Address - Phone:740-353-3189
Practice Address - Fax:740-353-7672
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350378582088P0231X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2088P0231XAllopathic & Osteopathic PhysiciansUrologyPediatric Urology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0431081Medicaid
OH0431081Medicaid
OHES0478813Medicare ID - Type Unspecified