Provider Demographics
NPI:1770592750
Name:PLAUTH, WILLIAM H III (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:H
Last Name:PLAUTH
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:455 SAINT MICHAELS DR
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-7601
Mailing Address - Country:US
Mailing Address - Phone:505-989-6130
Mailing Address - Fax:505-820-5408
Practice Address - Street 1:455 SAINT MICHAELS DR
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-7601
Practice Address - Country:US
Practice Address - Phone:505-989-6130
Practice Address - Fax:505-820-5408
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2000-268207RH0002X
CODR.0053245208M00000X
NM2000268207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMNM002T08OtherBCBS NM
1927317OtherUHC
202018057OtherPRESBYTERIAN HEALTH PLAN
NM79684Medicaid
QMP000003381641OtherMOLINA
NM79684Medicaid