Provider Demographics
NPI:1093840902
Name:FINK, WILLIAM LOUIS (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:LOUIS
Last Name:FINK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1707 MAIN ST
Mailing Address - Street 2:SUITE 404
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-7407
Mailing Address - Country:US
Mailing Address - Phone:303-776-9797
Mailing Address - Fax:303-776-7693
Practice Address - Street 1:1707 MAIN ST
Practice Address - Street 2:SUITE 404
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-7407
Practice Address - Country:US
Practice Address - Phone:303-776-9797
Practice Address - Fax:303-776-7693
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO284342084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO2961-1Medicare ID - Type UnspecifiedPSYCHIATRIST ADULT