Provider Demographics
NPI:1407161268
Name:PATZ, WILLIAM J (PA)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:J
Last Name:PATZ
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2829 GEORGIA ST NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-3419
Mailing Address - Country:US
Mailing Address - Phone:505-280-9214
Mailing Address - Fax:
Practice Address - Street 1:2829 GEORGIA ST NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-3419
Practice Address - Country:US
Practice Address - Phone:505-280-9214
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-17
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant