Provider Demographics
NPI:1649253584
Name:MILANO, WILLIAM J (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:J
Last Name:MILANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1627 E 18TH ST
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-4209
Mailing Address - Country:US
Mailing Address - Phone:970-663-0135
Mailing Address - Fax:970-461-1422
Practice Address - Street 1:2555 E 13TH ST
Practice Address - Street 2:SUITE 110
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80537-5113
Practice Address - Country:US
Practice Address - Phone:970-461-6140
Practice Address - Fax:970-461-6135
Is Sole Proprietor?:No
Enumeration Date:2005-11-23
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO23497207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01234970Medicaid
CO10025519400Medicaid
CO01234970Medicaid
COC801405Medicare PIN
COP00272569Medicare PIN