Basic Information
Provider Information
NPI: 1366581159
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MCNETT
FirstName: WILLIAM
MiddleName: G.
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: P.O. BOX 191
Address2:  
City: ROCKLAND
State: DE
PostalCode: 197230191
CountryCode: US
TelephoneNumber: 3026514000
FaxNumber: 3026514945
Practice Location
Address1: 833 CHESTNUT STREET EAST
Address2: SUITE 300
City: PHILADELPHIA
State: PA
PostalCode: 191074405
CountryCode: US
TelephoneNumber: 2159557800
FaxNumber: 2159239383
Other Information
ProviderEnumerationDate: 02/06/2007
LastUpdateDate: 07/19/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000XMD035255EPAY Allopathic & Osteopathic PhysiciansPediatrics 
208D00000XMD035255EPAN Allopathic & Osteopathic PhysiciansGeneral Practice 
208M00000XMD035255EPAN Allopathic & Osteopathic PhysiciansHospitalist 

ID Information
IDTypeStateIssuerDescription
410641505MD MEDICAID
159759305PA MEDICAID
750790905NJ MEDICAID


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