Provider Demographics
NPI:1760487706
Name:KUO, WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:KUO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4811 E GRANT RD STE 261
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-2776
Mailing Address - Country:US
Mailing Address - Phone:520-618-1010
Mailing Address - Fax:520-784-7040
Practice Address - Street 1:395 N SILVERBELL RD
Practice Address - Street 2:STE 315
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85745-2686
Practice Address - Country:US
Practice Address - Phone:520-618-1010
Practice Address - Fax:520-784-7040
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2017-10-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ29306208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ589278Medicaid
AZH36668Medicare UPIN
AZ589278Medicaid