Basic Information
| Provider Information | |||||||||
| NPI: | 1306842570 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GARRETSON | ||||||||
| FirstName: | WILLIAM | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2935 THOUSAND OAKS | ||||||||
| Address2: | SUITE 294 | ||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782473316 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2104941100 | ||||||||
| FaxNumber: | 2104941117 | ||||||||
| Practice Location | |||||||||
| Address1: | 1613 N MCKENZIE ST | ||||||||
| Address2: | |||||||||
| City: | FOLEY | ||||||||
| State: | AL | ||||||||
| PostalCode: | 365352247 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2519493920 | ||||||||
| FaxNumber: | 2519493930 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/22/2005 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | DO208 | AL | N | Allopathic & Osteopathic Physicians | Surgery | 2086S0102X | DO208 | AL | N | Allopathic & Osteopathic Physicians | Surgery | Surgical Critical Care | 2086S0129X | DO208 | AL | Y | Allopathic & Osteopathic Physicians | Surgery | Vascular Surgery |
ID Information
| ID | Type | State | Issuer | Description | 051099973 | 01 | AL | BLUE CROSS/BLUE SHIELD | OTHER | 88588 | 01 | AL | HEALTH PARTNERS | OTHER | 000099973 | 05 | AL | MEDICAID | 020047703 | 01 | AL | RAILROAD MEDICARE | OTHER |