Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | 46083 | KS |
NPI | 1063604940 |
---|---|
Provider Name | William T Carl |
First Address | Pittsburg, KS 66762-2546 |
Second Address | Pittsburg, KS 66762-2546 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2007 |
Last Update Date | 31/12/2020 |