Provider Demographics
NPI:1356316228
Name:CHO, WILLIAM H (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:H
Last Name:CHO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:4455 S I 19 FRONTAGE RD
Mailing Address - Street 2:
Mailing Address - City:GREEN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85614-5884
Mailing Address - Country:US
Mailing Address - Phone:520-393-4937
Mailing Address - Fax:833-605-7237
Practice Address - Street 1:4475 S I 19 FRONTAGE RD STE 255
Practice Address - Street 2:
Practice Address - City:GREEN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85614-6365
Practice Address - Country:US
Practice Address - Phone:520-393-4863
Practice Address - Fax:833-605-7237
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-22
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS04-26098174400000X
CAC42239208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAC42239OtherMEDICAL STATE LICENSE
KS059062OtherBLUE CROSS/BLUE SHIELD
KS340012687OtherRAILROAD MEDICARE
KS100185280BMedicaid
AZ497557Medicaid