Individual
DR. WILLIAM VICTOR FATTIG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
723 FLACK AVE, ALLIANCE, NE 69301-3514
(308) 225-4498
(308) 629-1499
Mailing address
723 FLACK AVE, ALLIANCE, NE 69301-3514
(308) 225-4498
(308) 629-1499
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
21201
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200269730A
KANSAS MEDICAID
KS
01
—
28D1030805
CLIA
NE
01
—
35808
MIDLANDS
NE
01
—
P00181202
RR MEDICARE
NE
Enumeration date
10/24/2006
Last updated
08/15/2016
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