Provider Demographics
NPI:1174534887
Name:ORTHOPAEDIC SURGICAL CARE INSTITUTE
Entity type:Organization
Organization Name:ORTHOPAEDIC SURGICAL CARE INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHOPAEDIC SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:G
Authorized Official - Last Name:MCDONALD
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:765-827-6724
Mailing Address - Street 1:PO BOX 246
Mailing Address - Street 2:
Mailing Address - City:CONNERSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47331
Mailing Address - Country:US
Mailing Address - Phone:765-827-6724
Mailing Address - Fax:765-827-7972
Practice Address - Street 1:1300 NORTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:RUSHVILLE
Practice Address - State:IN
Practice Address - Zip Code:46173
Practice Address - Country:US
Practice Address - Phone:765-932-5788
Practice Address - Fax:765-827-7972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01055711A207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000322039OtherBC/BS
IN211280AMedicare ID - Type Unspecified
IN000000322039OtherBC/BS