# WILLIAM T. THISTLETHWAITE M.D. PLLC

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

## Provider details

- **NPI number:** 1710196951
- **Authorized official:** BECKY RUSSEL (OFFICE MANAGER)
- **Authorized official phone:** (270) 629-3331

## Contact information

- **Practice address:** 1012C GLENVIEW DR, GLASGOW, KY 42141-3424
- **Practice address phone:** (270) 629-3331
- **Practice address fax:** (270) 629-3330
- **Mailing address:** PO BOX 1147, GLASGOW, KY 42142
- **Mailing address phone:** (270) 629-3331
- **Mailing address fax:** (270) 629-3330

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | 37101 | KY | Yes |

## Other

- **Enumeration date:** 05/22/2007
- **Last updated:** 03/12/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000368126 | ANTHEM BLUE CROSS | KY |
| 05 | — | 64048085 | — | KY |