Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0129X | Vascular Surgeon | 034166 | GA |
Y | 2086S0129X | Vascular Surgeon | ME146721 | FL |
NPI | 1003883612 |
---|---|
Provider Name | William J Kaiser |
First Address | Pensacola, FL 32524-1982 |
Second Address | Pensacola, FL 32504-8734 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2006 |
Last Update Date | 13/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
205810921A | (05) | GA |
205810921B | (05) | GA |
H95175 | (02) | GA |