Individual
MR. WILLIAM BRUCE GADDIS III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BA, CDC I
Contact information
Practice address
122 1ST AVE STE 600, FAIRBANKS, AK 99701-4899
(907) 459-3800
Mailing address
122 1ST AVE STE 600, FAIRBANKS, AK 99701-4899
(907) 459-3800
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
4350
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1558836221
—
AK
Enumeration date
10/09/2018
Last updated
04/18/2019
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