Basic Information
| Provider Information | |||||||||
| NPI: | 1093357675 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCFILLIN | ||||||||
| FirstName: | WILLIAM | ||||||||
| MiddleName: | FRANCIS | ||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5501 OLD YORK RD STE 1 | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191413098 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2154567979 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 5501 OLD YORK RD STE 1 | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191413098 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2154567979 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/15/2019 | ||||||||
| LastUpdateDate: | 10/15/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 125728 | PA | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.