Individual
DR. WILLIAM W FISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9784 N ASH AVE, KANSAS CITY, MO 64157-9742
(816) 781-4244
(816) 781-3542
Mailing address
5301 FARAON ST, SAINT JOSEPH, MO 64506-3512
(816) 271-7861
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R4C24
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1821090598
—
MO
01
—
MA4170078
MEDICARE PTAN
MO
01
—
MDR4C24
STATE LICENSE
MO
Enumeration date
08/12/2005
Last updated
12/19/2018
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