Provider Demographics
NPI:1699719633
Name:STAPLES, WILLIAM HOWARD (PT)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:HOWARD
Last Name:STAPLES
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:849 IRONWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46033-9200
Mailing Address - Country:US
Mailing Address - Phone:317-788-2112
Mailing Address - Fax:317-788-3542
Practice Address - Street 1:849 IRONWOOD DR
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46033-9200
Practice Address - Country:US
Practice Address - Phone:317-788-2112
Practice Address - Fax:317-844-5986
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05002231A2251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics