Provider Demographics
NPI:1487681144
Name:DOLAN, WILLIAM VINCENT (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:VINCENT
Last Name:DOLAN
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 1:9027 N CAVE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-2522
Mailing Address - Country:US
Mailing Address - Phone:602-892-5065
Mailing Address - Fax:602-532-7881
Practice Address - Street 1:9027 N CAVE CREEK RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-2522
Practice Address - Country:US
Practice Address - Phone:602-892-5065
Practice Address - Fax:602-532-7881
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ11468208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery