Provider Demographics
NPI:1063898856
Name:WILLIAM M. STEELY M.D. PC
Entity type:Organization
Organization Name:WILLIAM M. STEELY M.D. PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:MORRIS
Authorized Official - Last Name:STEELY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:931-552-0380
Mailing Address - Street 1:787 WEATHERLY DR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-8949
Mailing Address - Country:US
Mailing Address - Phone:931-552-0380
Mailing Address - Fax:931-551-3157
Practice Address - Street 1:787 WEATHERLY DR
Practice Address - Street 2:SUITE 400
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-8949
Practice Address - Country:US
Practice Address - Phone:931-552-0380
Practice Address - Fax:931-551-3157
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-04
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD018913208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNC77176Medicare UPIN