Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 37956 | AZ |
NPI | 1003935479 |
---|---|
Provider Name | Dr. William John Badger |
First Address | Flagstaff, AZ 86003-1210 |
Second Address | Flagstaff, AZ 86001-1483 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2007 |
Last Update Date | 12/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1003935479 | AETNA (01) | AZ |
1003935479 | AZFMC (01) | AZ |
1003935479 | BCBS (01) | AZ |
1003935479 | CIGNA (01) | AZ |
1003935479 | HUMANA (01) | AZ |
1003935479 | UHC (01) | AZ |
328461 | (05) | AZ |
Z129226 | MEDICARE (01) | AZ |