Provider Demographics
NPI:1063460038
Name:ACCOMANDO, WILLIAM JOSEPH (DPM)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:JOSEPH
Last Name:ACCOMANDO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10789 N 90TH ST
Mailing Address - Street 2:STE 103
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260
Mailing Address - Country:US
Mailing Address - Phone:480-451-0123
Mailing Address - Fax:480-451-4876
Practice Address - Street 1:10789 N 90TH ST
Practice Address - Street 2:STE 103
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260
Practice Address - Country:US
Practice Address - Phone:480-451-0123
Practice Address - Fax:480-451-4876
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-04
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ338213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ0193360OtherBC
AZ69519Medicare PIN
AZ0193360OtherBC