Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 288 | AZ |
NPI | 1083716658 |
---|---|
Provider Name | William Harant |
First Address | Tucson, AZ 85710-2117 |
Second Address | Tucson, AZ 85710-2117 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2006 |
Last Update Date | 19/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
480015637 | RAILROAD MEDICARE (01) | AZ |
701260 | (05) | AZ |