Individual
DR. WILLIAM JOSEPH WYATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
505 S BURG ST, KIMBALL, NE 69145-1313
(308) 235-1951
(308) 235-1954
Mailing address
505 S BURG ST, KIMBALL, NE 69145-1313
(308) 235-1951
(308) 235-1954
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
20963
NE
208200000X
Plastic Surgery Physician
6212A
WY
2082S0105X
Surgery of the Hand (Plastic Surgery) Physician
20963
NE
2082S0105X
Surgery of the Hand (Plastic Surgery) Physician
6212A
WY
208600000X
Surgery Physician
6212A
WY
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
20963
NE
2086S0122X
Plastic and Reconstructive Surgery Physician
6212A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102753300
WORKERS COMP
WY
05
—
113999100
—
WY
Enumeration date
09/07/2006
Last updated
02/18/2020
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