Provider Demographics
NPI:1619193943
Name:SAXENA, WILL (MD)
Entity Type:Individual
Prefix:
First Name:WILL
Middle Name:
Last Name:SAXENA
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 1:2941 SIERRA CT SW
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52240-8503
Mailing Address - Country:US
Mailing Address - Phone:319-337-7642
Mailing Address - Fax:
Practice Address - Street 1:1314 S STUART ST
Practice Address - Street 2:
Practice Address - City:SIGOURNEY
Practice Address - State:IA
Practice Address - Zip Code:52591-1154
Practice Address - Country:US
Practice Address - Phone:641-622-3840
Practice Address - Fax:641-622-3529
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2009-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA38057207Q00000X
ALL-2646207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1619193943Medicaid
IAP00694368OtherRR MEDICARE
IAP00694368OtherRR MEDICARE