Provider Demographics
NPI:1578508016
Name:DAOUST, WILLIAM S (CRNA)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:S
Last Name:DAOUST
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6701 AIRPORT BLVD
Mailing Address - Street 2:SUITE D430B
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-6705
Mailing Address - Country:US
Mailing Address - Phone:979-393-9940
Mailing Address - Fax:
Practice Address - Street 1:6701 AIRPORT BLVD
Practice Address - Street 2:SUITE D430B
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-6705
Practice Address - Country:US
Practice Address - Phone:979-393-9940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-18
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-082293367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051513188Medicaid
MS02821353Medicaid
AL51513188OtherBCBS
AL051513188Medicare PIN
P23588Medicare UPIN
AL051513188Medicaid