Individual
MR. WILLIAM T FANNIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9 FLORA STREET, PIKEVILLE, KY 41501
(606) 432-4183
(606) 432-4270
Mailing address
1358 WATERGAP RD, PRESTONSBURG, KY 41653-1721
(606) 432-4183
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
KY23326
KY
207QA0401X
Addiction Medicine (Family Medicine) Physician
23326
KY
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
23326
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64233265
—
KY
Enumeration date
12/12/2006
Last updated
12/13/2019
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