William J. Conrad, P.A.-C
Individual provider Active NPI Medical Physician Assistant · Wray, CO
NPI 1811954563 · NPPES record last updated Dec 17, 2009
Key facts
- NPI
- 1811954563
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- 6 (CO)
- Practice address
- 1017 W 7TH St
Wray, CO 80758-1420 - Phone
- (970) 332-4895
- Fax
- (370) 332-3235
- NPI assigned
- Apr 27, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6 | CO | MD | Medical Physician Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 6 | CO | Yes |
Addresses
Primary practice location
1017 W 7TH St
Wray, CO 80758-1420
Mailing address
PO Box 216
Wray, CO 80758-0216
Phone (970) 332-4895
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04650040 | Medicaid | CO |
Other providers in Wray, CO
- Faith Kelley Chenoweth
- Venessa Christina
- City of Wray
- Gregory Collins
- Maria Helena Conrad
- Jesse Cushen
- Tiffany Lynn Deering
- Dunn Chiropractic of Wray Inc.
- Melvin Dustin Dunn
- Karmon Ebright
All providers in Wray, CO · Medical Physician Assistant in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 17, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.