Collison, William Wade

Collison, William Wade is an sole proprietor health care provider with primary practice located at 1050 Gail Gardner Way 200, Prescott AZ 86305-1630. He recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery, which is considered as his primary health care specialty. Collison, William Wade can be contacted via phone (928) 778-3838.

Contact Information

Primary practice address
1050 Gail Gardner Way 200 Prescott AZ 86305-1630
Phone: (928) 778-3838
Fax: (928) 778-5630
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery 2086S0122X 10644 Arizona

Profile Details

NPI number 1154314730
LBN Legal business name Collison, William Wade
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 29th, 2005
Last updated Mar 27th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154314730 NPPES
Arizona Other 21-13-A644 WORKER'S COMPENSATION
Arizona Other 24000709 WORKER'S COMPENSATION
Arizona MEDICAID 238354 WORKER'S COMPENSATION

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