William H Dillon, DO
Individual provider Active NPI Ophthalmology Physician · Immokalee, FL
NPI 1154385342 · NPPES record last updated Jan 23, 2017
Key facts
- NPI
- 1154385342
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Ophthalmology Physician 207W00000X
- License
- OS8086 (FL)
- Practice address
- 1320 N 15TH St
Immokalee, FL 34142-2875 - Phone
- (239) 657-4486
- Fax
- (239) 657-4770
- NPI assigned
- Apr 14, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2067 | OK | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Florida Retina Institute James a Staman MD LLC | Ophthalmology | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 059910 | GA | |
| Ophthalmology Physician | 207W00000X | OS8086 | FL | Yes |
Addresses
Primary practice location
1320 N 15TH St
Immokalee, FL 34142-2875
Mailing address
4101 Evans Ave
Fort Myers, FL 33901-9310
Phone (239) 335-1944
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 47903 | Other | FL | BLUE CROSS BLUE SHIELD |
| 4472251 | Other | FL | CIGNA |
| 4370751 | Other | FL | AETNA |
| 235465200 | Medicaid | FL |
Other providers in Immokalee, FL
- David Lawrence Mental Health Center Inc
- Ruth Davies
- Adela M De Vera
- Lindsay Nahara Dessources
- Yira Mercedes Diaz Mena
- Dao-Tien Duong
- Exclusive Hands Homecare LLC
- Eye Associates of Manatee LLP
- Natalia Falcon Banchs
- Gabriel N Flores
All providers in Immokalee, FL · Ophthalmology Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 23, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.