Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | M-10392 | ID |
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | MD60011529 | WA |
NPI | 1235333188 |
---|---|
Provider Name | Dr. William Thomas Magee |
First Address | Liberty Lake, WA 99019-0421 |
Second Address | Colville, WA 99114-3354 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2007 |
Last Update Date | 17/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000010168477 | REGENCE (01) | ID |
808123500 | (05) | ID |