William K Abbott, CERTIFIED PROSTHETIS

Individual provider Active NPI Orthotic Fitter · Jefferson City, MO

NPI 1831133396 · NPPES record last updated Nov 8, 2007

Key facts

NPI
1831133396
Entity type
Individual (NPI type 1)
Primary specialty
Orthotic Fitter 225000000X
License
CERTIFIED (MO)
Practice address
1735 Southwest Blvd
Jefferson City, MO 65109-2435
Phone
(573) 635-0006
Fax
(573) 635-2228
NPI assigned
Jun 15, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
CERTIFIEDMOMDOrthotic Fitter

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia O & P Labs Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Orthotic Fitter 225000000X CERTIFIED MO Yes

Addresses

Primary practice location

1735 Southwest Blvd
Jefferson City, MO 65109-2435

Mailing address

1735 Southwest Blvd
Jefferson City, MO 65109-2435
Phone (573) 635-0006

Other identifiers

IdentifierTypeStateIssuer
122475OtherMOBCBS PROVIDER#
433956OtherMOHEALTHLINK PROVIDER#

Other providers in Jefferson City, MO

All providers in Jefferson City, MO · Orthotic Fitter in Missouri

Sources for this page

Verify at the official NPI Registry.