William Wade Collison
Plastic and Reconstructive Surgery
1050 Gail Gardner Way 200
Prescott
, Arizona 86305-1630
William Wade Collison
Plastic and Reconstructive Surgery
1050 Gail Gardner Way 200
Prescott
, Arizona 86305-1630
(928) 458-2039
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About
Features
Specialties
- Plastic and Reconstructive Surgery
Languages spoken
- English
Location
First Address
- William Wade Collison
- Po Box 10880
- Prescott, AZ
- Zip : 86304-0880
- Fax : (928) 458-2039
- Phone : (928) 759-5987
Second Address
- William Wade Collison
- 1050 Gail Gardner Way 200
- Prescott, AZ
- Zip : 86305-1630
- Fax : (928) 778-5630
- Phone : (928) 778-3838
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2086S0122X | Plastic and Reconstructive Surgery | 10644 | AZ |
National Provider Identifier
| NPI | 1154314730 |
|---|---|
| Provider Name | William Wade Collison |
| First Address | Prescott, AZ 86304-0880 |
| Second Address | Prescott, AZ 86305-1630 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 29/08/2005 |
| Last Update Date | 27/03/2018 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 21-13-A644 | WORKER'S COMPENSATION (01) | AZ |
| 238354 | (05) | AZ |
| 24000709 | RAILROAD MEDICARE (01) | AZ |
| D36697 | (02) | AZ |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.