Basic Information
| Provider Information | |||||||||
| NPI: | 1497801112 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WILL | ||||||||
| FirstName: | ALBERT | ||||||||
| MiddleName: | DOUGLAS | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 21530 | ||||||||
| Address2: | |||||||||
| City: | CARSON CITY | ||||||||
| State: | NV | ||||||||
| PostalCode: | 897211530 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7758842455 | ||||||||
| FaxNumber: | 7758840345 | ||||||||
| Practice Location | |||||||||
| Address1: | 152 PIONEER LN | ||||||||
| Address2: | SUITE A | ||||||||
| City: | BISHOP | ||||||||
| State: | CA | ||||||||
| PostalCode: | 935142563 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7608732605 | ||||||||
| FaxNumber: | 7608732769 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/26/2007 | ||||||||
| LastUpdateDate: | 07/29/2013 | ||||||||
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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 | 2084N0400X | G40219 | CA | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology |
No ID Information.