Provider Demographics
NPI:1629321773
Name:TOALSON, WILLIAM BENTON (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:BENTON
Last Name:TOALSON
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 1:3208 W 71ST ST
Mailing Address - Street 2:71ST ST.
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66208-3111
Mailing Address - Country:US
Mailing Address - Phone:913-236-8656
Mailing Address - Fax:
Practice Address - Street 1:3208 W 71ST ST
Practice Address - Street 2:71ST ST.
Practice Address - City:PRAIRIE VILLAGE
Practice Address - State:KS
Practice Address - Zip Code:66208-3111
Practice Address - Country:US
Practice Address - Phone:913-236-8656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-25
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN04-13128174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist