Provider Demographics
NPI:1184706608
Name:TRASK, WILLIAM SPRAGUE IV (DO)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:SPRAGUE
Last Name:TRASK
Suffix:IV
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 21147
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80308-4147
Mailing Address - Country:US
Mailing Address - Phone:303-415-2532
Mailing Address - Fax:303-785-1725
Practice Address - Street 1:4747 ARAPAHOE AVE
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-1131
Practice Address - Country:US
Practice Address - Phone:303-415-2532
Practice Address - Fax:303-785-1725
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2019-03-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAOL20000111207L00000X
WAOP60150344207L00000X
CO49491207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
8891904Medicare PIN