Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

William Blake McKibbin, MD

Individual provider Surgery Physician · NPI 1295739878

William Blake McKibbin, MD is a General Surgery in Fishersville, Virginia. Qualified in 1999, 27 years ago. Practices with Bolivar Physician Practices LLC, an 18-clinician group and accepts Medicare assignment. Licensed in Georgia and Virginia.

Years since qualifying
27
Licensed in
GA, VA
In the registry since
2005
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

16 Ivy Ridge Ln Ste 130
Fishersville, VA 22939-2354
Phone: (540) 332-5909
Fax: (540) 332-5910
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence 0101240500 (VA)
Surgery Physician Taxonomy 208600000X · Licence 052784 (GA)

Record details

NPI number1295739878
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 10, 2005
Last updated in NPPESFebruary 13, 2020
Certification dateFebruary 13, 2020
Mailing address16 Ivy Ridge Ln Ste 130, Fishersville, VA 22939-2354

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyGENERAL SURGERY
Medical schoolOTHER
Graduated 1999 (27 years in practice)
Group practice Bolivar Physician Practices Llc — 18 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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