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Individual

DR. WILLIAM HARSTON JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
208 S COURT ST, SCOTTSVILLE, KY 42164-1263
(270) 239-4000
(270) 796-9328
Mailing address
PO BOX 90039, BOWLING GREEN, KY 42102-9039
(270) 796-8800
(270) 796-9328

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
24447
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000044740
ANTHEM
KY
01
50006915
PASSPORT
KY
05
64244478
KY
01
700005564
RAILROAD MEDICARE
KY
Enumeration date
06/09/2005
Last updated
06/06/2014
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