Bacon, William T

Bacon, William T is an individual health care provider with primary practice located at 1650 Hospital Dr Ste 800 , Santa Fe NM 87505-4789. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Bacon, William T can be contacted via phone (505) 395-3000.

Contact Information

Primary practice address
1650 Hospital Dr Ste 800 Santa Fe NM 87505-4789
Phone: (505) 395-3000
Fax: (505) 982-5003
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 2001-PA36 New Mexico

Profile Details

NPI number 1730181942
LBN Legal business name Bacon, William T
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 1st, 2005
Last updated Sep 1st, 2022 - about 2 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730181942 NPPES
New Mexico MEDICAID 05638852

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