Provider Demographics
NPI:1366585572
Name:GARNER, WILLIAM H III (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:H
Last Name:GARNER
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 MARKET STREET
Mailing Address - Street 2:
Mailing Address - City:CHARLESTOWN
Mailing Address - State:IN
Mailing Address - Zip Code:47111
Mailing Address - Country:US
Mailing Address - Phone:812-256-7442
Mailing Address - Fax:812-256-7835
Practice Address - Street 1:2100 MARKET STREET
Practice Address - Street 2:
Practice Address - City:CHARLESTOWN
Practice Address - State:IN
Practice Address - Zip Code:47111
Practice Address - Country:US
Practice Address - Phone:812-256-7830
Practice Address - Fax:812-256-7835
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01031544208600000X
IN01031544A208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000042422OtherANTHEM MEDICAID
IN021760854OtherRAILROAD MEDICARE
IN100138490OtherMDWISE HOOSIER ALLIANCE
IN000000042422OtherANTHEM
IN100138490OtherMANAGED HEALTH SERVICES
IN000000042422OtherINDIANA COMPREHENSIVE
IN100138490Medicaid
IN000000042422OtherHEALTHLINK
KY000000042422OtherANTHEM
IN242150BOtherUNICARE MEDICARE
IN000000042422OtherONE NATION BENEFIT
IN000000042422OtherUNICARE
IN242150BOtherUNICARE MEDICARE
IN100138490Medicaid