# WILLIAM NICHOLSON AINSWORTH IV MD

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033517784
- **Authorized official:** DR. WILLIAM NICHOLSON AINSWORTH IV M.D. (OWNER)
- **Authorized official phone:** (386) 328-8856

## Contact information

- **Practice address:** 6121 CRILL AVE, PALATKA, FL 32177-3875
- **Practice address phone:** (386) 328-8856
- **Practice address fax:** (386) 328-7646
- **Mailing address:** 6121 CRILL AVE, PALATKA, FL 32177-3875
- **Mailing address phone:** (386) 328-8856
- **Mailing address fax:** (386) 328-7646

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | ME0047518 | FL | Yes |

## Other

- **Enumeration date:** 12/11/2014
- **Last updated:** 12/11/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 043732800 | — | FL |