Provider Demographics
NPI:1497788160
Name:GANZ, WILLIAM FRANCIS (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:FRANCIS
Last Name:GANZ
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 1:2236 N MERRIT CRK LOOP STE A
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-4960
Mailing Address - Country:US
Mailing Address - Phone:208-625-3800
Mailing Address - Fax:208-625-3801
Practice Address - Street 1:2236 N MERRIT CREEK LOOP
Practice Address - Street 2:SUITE A
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-4960
Practice Address - Country:US
Practice Address - Phone:208-664-5467
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-08
Last Update Date:2019-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM8313207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8295446Medicaid
MO0039572Medicaid
WA0191891OtherLABOR AND INDUSTRIES
STERLINGOther1101486
B1352OtherPREMERA BLUE CROSS
IDB1352OtherBLUE CROSS OF IDAHO
ID000010034455OtherREGENCE BLUE SHIELD
ID806085500Medicaid
P00173147OtherRR MEDICARE
F00615Medicare UPIN
WA8295446Medicaid