Provider Demographics
NPI:1366462467
Name:CARR, WILLIAM DAVID (PHD, ATC)
Entity Type:Individual
Prefix:PROF
First Name:WILLIAM
Middle Name:DAVID
Last Name:CARR
Suffix:
Gender:M
Credentials:PHD, ATC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:901 S. NATIONAL AVE
Mailing Address - Street 2:PROF 161
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65897
Mailing Address - Country:US
Mailing Address - Phone:417-836-8220
Mailing Address - Fax:785-864-3343
Practice Address - Street 1:1301 SUNNYSIDE AVE # 161
Practice Address - Street 2:UNIVERSITY OF KANSAS
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66045-7567
Practice Address - Country:US
Practice Address - Phone:785-864-0799
Practice Address - Fax:785-864-3343
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2015-05-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS24-004812255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer