Anderson, William Wallace
Anderson, William Wallace is an individual health care provider with primary practice located at 1400 Barbara Loop Se Ste A , Rio Rancho NM 87124-1088. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Anderson, William Wallace can be contacted via phone (505) 892-9711.Contact Information
Primary practice address
1400 Barbara Loop Se Ste A
Rio Rancho NM 87124-1088
Phone: (505) 892-9711
Fax: (505) 892-5206
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 78-105 | New Mexico |
Profile Details
| NPI number | 1194800334 |
|---|---|
| LBN Legal business name | Anderson, William Wallace |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 26th, 2006 |
| Last updated | Aug 17th, 2018 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1194800334 | NPPES |
| New Mexico | Other | 85-0455201 | FEDID |
| New Mexico | Other | 850455201 | FEDID |
| New Mexico | MEDICAID | 17418 | FEDID |
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