Provider Demographics
NPI:1265451124
Name:BROPHY, WILLIAM HENRY (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:HENRY
Last Name:BROPHY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8111 E THOMAS RD STE 124
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-5876
Mailing Address - Country:US
Mailing Address - Phone:602-954-0444
Mailing Address - Fax:
Practice Address - Street 1:8111 E THOMAS RD STE 124
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-5876
Practice Address - Country:US
Practice Address - Phone:602-954-0444
Practice Address - Fax:602-952-7146
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ17279207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ17279OtherSTATE MEDICAL LICENSE NO.
C99204Medicare UPIN