Correll, William T.

Correll, William T. is an individual health care provider with primary practice located at 1919 Lake Ave Ste 106 , Plymouth IN 46563-7830. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Correll, William T. can be contacted via phone (574) 335-5220.

Contact Information

Primary practice address
1919 Lake Ave Ste 106 Plymouth IN 46563-7830
Phone: (574) 335-5220
Fax: (574) 335-0859
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 5101014163DO Michigan
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 5101014163 Michigan
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 02007492A Indiana

Profile Details

NPI number 1154371581
LBN Legal business name Correll, William T.
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date May 10th, 2006
Last updated May 13th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154371581 NPPES
Indiana MEDICAID 300082849
Indiana MEDICAID 4849184
Indiana MEDICAID 4849193
Indiana Other 1022813
Indiana MEDICAID 4963714
Indiana Other 080D410020
Indiana MEDICAID 4849166
Indiana Other 1022851

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