Provider Demographics
NPI:1194726935
Name:STILES, WILLIAM K (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:K
Last Name:STILES
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 1:885 MISSION ST SE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-6222
Mailing Address - Country:US
Mailing Address - Phone:503-585-5585
Mailing Address - Fax:503-399-1659
Practice Address - Street 1:885 MISSION ST SE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-6222
Practice Address - Country:US
Practice Address - Phone:503-585-5585
Practice Address - Fax:503-399-1659
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD13512207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR283358Medicaid
OR060044831OtherRAILROAD MEDICARE
OR283358Medicaid
OR100603Medicare PIN
ORR159996Medicare PIN