Provider Demographics
NPI:1962427674
Name:GEORGE, WILLIAM DON (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:DON
Last Name:GEORGE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:BILL
Other - Middle Name:
Other - Last Name:GEORGE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2849 COUNTY ROAD 110
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:MO
Mailing Address - Zip Code:64836-3230
Mailing Address - Country:US
Mailing Address - Phone:417-358-6650
Mailing Address - Fax:
Practice Address - Street 1:2849 COUNTY ROAD 110
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:MO
Practice Address - Zip Code:64836-3230
Practice Address - Country:US
Practice Address - Phone:417-358-6650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR3505207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
015050053Medicare ID - Type Unspecified
A11818Medicare UPIN