Provider Demographics
NPI:1881680171
Name:BARTLETT, WILLIAM H (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:H
Last Name:BARTLETT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:380 TESCONI CT
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95401-4653
Mailing Address - Country:US
Mailing Address - Phone:707-544-3375
Mailing Address - Fax:707-544-0808
Practice Address - Street 1:380 TESCONI CT
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95401-4653
Practice Address - Country:US
Practice Address - Phone:707-544-3375
Practice Address - Fax:707-544-0808
Is Sole Proprietor?:No
Enumeration Date:2005-09-22
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG085502207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G855020Medicaid
CA00G855020Medicare ID - Type Unspecified
CAF08530Medicare UPIN