Basic Information
| Provider Information | |||||||||
| NPI: | 1851364426 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | THORNTON | ||||||||
| FirstName: | WILLIAM | ||||||||
| MiddleName: | COOPER | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1412 WALES DR | ||||||||
| Address2: | |||||||||
| City: | HIGH POINT | ||||||||
| State: | NC | ||||||||
| PostalCode: | 272627341 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3368832875 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 350 N COX ST | ||||||||
| Address2: | SUITE 20 | ||||||||
| City: | ASHEBORO | ||||||||
| State: | NC | ||||||||
| PostalCode: | 272035566 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3366723200 | ||||||||
| FaxNumber: | 3366297349 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/13/2006 | ||||||||
| LastUpdateDate: | 07/09/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0300X | 20757 | NC | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Geriatric Medicine |
ID Information
| ID | Type | State | Issuer | Description | 31776 | 01 | NC | MEDCOST | OTHER | 401438 | 01 | NC | UNITED HEALTH CARE | OTHER | 83327 | 01 | NC | BCBS | OTHER | 89012FW | 05 | NC | MEDICAID | 8983327 | 05 | NC | MEDICAID | 243359 | 01 | NC | MAMSI & ALLIANCE | OTHER | 1324 | 01 | NC | CIGNA | OTHER | 012FW | 01 | NC | BCBS GROUP # | OTHER | 19453 | 01 | NC | PARTNERS | OTHER |