Provider Demographics
NPI:1508844093
Name:WALL, WILLIAM JOSEPH III (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:JOSEPH
Last Name:WALL
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:4045 E BELL RD
Mailing Address - Street 2:STE. 143
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-2236
Mailing Address - Country:US
Mailing Address - Phone:602-867-0404
Mailing Address - Fax:602-788-0893
Practice Address - Street 1:9582 W COLONIAL DR
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-6992
Practice Address - Country:US
Practice Address - Phone:407-896-3055
Practice Address - Fax:407-865-6012
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2018-04-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AL000259402085R0202X
CAA546482085R0202X
FLME946412085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology