Individual
WILLIAM G TERPSTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
821 N DIXON RD, KOKOMO, IN 46901-1754
(765) 452-0878
(765) 452-1826
Mailing address
605 E 7TH ST, PO BOX 38, BURLINGTON, IN 46915-9441
(765) 566-3351
(765) 566-2250
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01025462
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000555849BC
ANTHEM BCBS
IN
05
—
100060020
—
IN
01
—
177280QQ
MEDICARE
IN
01
—
P00470036
RR MCR
IN
Enumeration date
12/28/2005
Last updated
03/24/2011
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