Provider Demographics
NPI:1881686368
Name:WEISS, WILLIAM L (MD, PC)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:L
Last Name:WEISS
Suffix:
Gender:M
Credentials:MD, PC
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 6011
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85338-0617
Mailing Address - Country:US
Mailing Address - Phone:623-537-5100
Mailing Address - Fax:623-537-5200
Practice Address - Street 1:9321 W THOMAS RD
Practice Address - Street 2:STE 400
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85037-3399
Practice Address - Country:US
Practice Address - Phone:623-537-5100
Practice Address - Fax:623-537-5200
Is Sole Proprietor?:No
Enumeration Date:2005-08-19
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ31284207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZH86549Medicare UPIN
AZZ82748Medicare PIN