Individual
WILLIAM GEORGE WALL II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2103 SILVA LANE, MOBERLY, MO 65270
(660) 263-1266
Mailing address
PO BOX 388, NEWTON, KS 67114-0388
(316) 281-3700
(316) 282-4322
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
150584
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
913871505
—
MO
Enumeration date
01/24/2006
Last updated
04/23/2008
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