Organization
WILLIAM T. THISTLETHWAITE M.D. PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BECKY RUSSEL (OFFICE MANAGER)
(270) 629-3331
Entity
Organization
Contact information
Practice address
1012C GLENVIEW DR, GLASGOW, KY 42141-3424
(270) 629-3331
(270) 629-3330
Mailing address
PO BOX 1147, GLASGOW, KY 42142
(270) 629-3331
(270) 629-3330
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
37101
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000368126
ANTHEM BLUE CROSS
KY
05
—
64048085
—
KY
Enumeration date
05/22/2007
Last updated
03/12/2008
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