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

William Russell Bacon, MD

Individual provider Diagnostic Radiology Physician · NPI 1609014489

William Russell Bacon, MD is a Diagnostic Radiology in Eden Prairie, Minnesota. Qualified in 2006, 20 years ago. Practices with Radiology Alliance PC, a 424-clinician group and accepts Medicare assignment. Licensed in Florida and Tennessee.

Years since qualifying
20
Licensed in
FL, TN
In the registry since
2009
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

11995 Singletree Ln Ste 500
Eden Prairie, MN 55344-5349
Phone: (952) 595-1301
Fax: (612) 294-4903
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence ME151240 (FL)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence 47338 (TN)

Record details

NPI number1609014489
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedFebruary 2, 2009
Last updated in NPPESAugust 1, 2022
Certification dateAugust 1, 2022
Mailing address11995 Singletree Ln Ste 500, Eden Prairie, MN 55344-5349

Medicare enrollment

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

Medicare specialtyDIAGNOSTIC RADIOLOGY
Medical schoolOTHER
Graduated 2006 (20 years in practice)
Group practice Radiology Alliance Pc — 424 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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