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Individual

MR. WILLIAM JOHN ED MC CORD JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
72 BRIAN CT, BOAZ, AL 35957-5897
(256) 593-4717
Mailing address
72 BRIAN CT, BOAZ, AL 35957-5897
(256) 593-4717

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1-079713
AL
367500000X
Certified Registered Nurse Anesthetist
Primary
1-079713
AL

Other

Enumeration date
05/13/2008
Last updated
01/15/2013
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