Provider Demographics
NPI:1588015309
Name:STROUD, BILLY J III
Entity Type:Individual
Prefix:
First Name:BILLY
Middle Name:J
Last Name:STROUD
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 STEDMAN ST
Mailing Address - Street 2:
Mailing Address - City:KETCHIKAN
Mailing Address - State:AK
Mailing Address - Zip Code:99901-6661
Mailing Address - Country:US
Mailing Address - Phone:907-228-0320
Mailing Address - Fax:907-228-0255
Practice Address - Street 1:1300 STEDMAN ST
Practice Address - Street 2:
Practice Address - City:KETCHIKAN
Practice Address - State:AK
Practice Address - Zip Code:99901-6661
Practice Address - Country:US
Practice Address - Phone:907-228-0320
Practice Address - Fax:907-228-0255
Is Sole Proprietor?:No
Enumeration Date:2016-06-22
Last Update Date:2016-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other