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Individual

WILLIAM JOSEPH DECKERT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1125 MADISON ST, JEFFERSON CITY, MO 65101-5227
(573) 632-5357
(573) 632-5876
Mailing address
PO BOX 843966, KANSAS CITY, MO 64184-3966
(573) 884-3300
(573) 884-0943

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
122556
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
127254
BLUE SHIELD
MO
01
765459
HEALTHLINK
MO
05
916290703
MO
Enumeration date
10/18/2006
Last updated
01/16/2025
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