Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | DO208 | AL |
N | 208600000X | Surgeon | DO208 | AL |
N | 2086S0102X | Surgical Critical Care | DO208 | AL |
Y | 2086S0129X | Vascular Surgeon | DO208 | AL |
NPI | 1306842570 |
---|---|
Provider Name | Dr. William Garretson |
First Address | San Antonio, TX 78247-3316 |
Second Address | Foley, AL 36535-2247 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2005 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000099973 | (05) | AL |
020047703 | RAILROAD MEDICARE (01) | AL |
051099973 | BLUE CROSS/BLUE SHIELD (01) | AL |
88588 | HEALTH PARTNERS (01) | AL |
E18509 | (02) | AL |