Individual
MR. WILLIAM T. KO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2224 W NORTHERN AVE STE D300, PHOENIX, AZ 85021
(602) 277-1449
(602) 277-9984
Mailing address
2224 W NORTHERN AVE STE D300, PHOENIX, AZ 85021-5099
(602) 277-1449
(602) 277-9984
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
26333
AZ
207ND0101X
MOHS-Micrographic Surgery Physician
26333
AZ
207NS0135X
Procedural Dermatology Physician
26333
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007180050
AETNA
AZ
01
—
070015308
RAILROAD MEDICARE
AZ
01
—
2Z2527
HEALTHNET
AZ
05
—
686868
—
AZ
01
—
8009018002
CIGNA
AZ
01
—
AZ0873220
BLUE CROSS
AZ
Enumeration date
06/07/2006
Last updated
10/25/2018
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