Provider Demographics
NPI:1023422532
Name:BOTTOMLEY, WILLIAM (DO)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:BOTTOMLEY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 W BETHANY HOME RD
Mailing Address - Street 2:PHOENIX BAPTIST FAMILY MEDICINE RESIDENCY
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85015-2443
Mailing Address - Country:US
Mailing Address - Phone:602-246-5658
Mailing Address - Fax:
Practice Address - Street 1:2000 W BETHANY HOME RD
Practice Address - Street 2:PHOENIX BAPTIST FAMILY MEDICINE RESIDENCY
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85015-2443
Practice Address - Country:US
Practice Address - Phone:602-246-5658
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-12
Last Update Date:2014-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZR2429207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine