Provider Demographics
NPI:1841259504
Name:CHASE, WILLIAM W (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:W
Last Name:CHASE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 COLONIAL CIR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NORWALK
Mailing Address - State:IA
Mailing Address - Zip Code:50211-9616
Mailing Address - Country:US
Mailing Address - Phone:515-285-3200
Mailing Address - Fax:515-285-3232
Practice Address - Street 1:801 COLONIAL CIR
Practice Address - Street 2:STE 200
Practice Address - City:NORWALK
Practice Address - State:IA
Practice Address - Zip Code:50211-9626
Practice Address - Country:US
Practice Address - Phone:515-285-3200
Practice Address - Fax:515-285-3232
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA34287207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1841259504Medicaid
IA5215319Medicaid
IA5215319Medicaid
IAH50997Medicare UPIN
IAI8322Medicare PIN
IA080194055Medicare PIN