Provider Demographics
NPI:1194735902
Name:NOWLIN, WILLIAM F JR (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:F
Last Name:NOWLIN
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:1200 ROOSEVELT PL
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383-3707
Mailing Address - Country:US
Mailing Address - Phone:219-464-2218
Mailing Address - Fax:219-477-4131
Practice Address - Street 1:1200 ROOSEVELT PL
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-3707
Practice Address - Country:US
Practice Address - Phone:219-464-2218
Practice Address - Fax:219-477-4131
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2011-01-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN22552208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000082834OtherANTHEM BLUE CROSS
IN100160080AMedicaid
IN000000082834OtherANTHEM BLUE CROSS