Provider Demographics
NPI:1760446892
Name:DENNIS, WILLIAM AUSTIN (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:AUSTIN
Last Name:DENNIS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5213 S ALSTON AVE
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-4430
Mailing Address - Country:US
Mailing Address - Phone:919-620-4917
Mailing Address - Fax:919-620-4921
Practice Address - Street 1:480 RUIN CREEK RD
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27536-2929
Practice Address - Country:US
Practice Address - Phone:252-492-3152
Practice Address - Fax:252-430-1928
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2012-05-24
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Provider Licenses
StateLicense IDTaxonomies
NC200200514207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89131VHMedicaid
NC89131VHMedicaid
NC2006639Medicare PIN