Provider Demographics
NPI:1730162827
Name:MARSH, WILLIAM STEVENS III (DO)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:STEVENS
Last Name:MARSH
Suffix:III
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5320 E CENTRAL TEXAS EXPY STE 105
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76543-5516
Mailing Address - Country:US
Mailing Address - Phone:254-519-1900
Mailing Address - Fax:254-519-1980
Practice Address - Street 1:5320 E CENTRAL TEXAS EXPY STE 105
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76543-5516
Practice Address - Country:US
Practice Address - Phone:254-519-1900
Practice Address - Fax:254-519-1980
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK7580208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX029536203Medicaid
TX8938MOOtherBLUE CROSS BLUE SHIELD
TX742914179OtherHUMANA/MILITARY-TRICARE
TX80495OtherSCOTT & WHITE PLAN
TXF44585Medicare UPIN
TX8938MOMedicare PIN