Healthcare Provider Details

I. General information

NPI: 1124006200
Provider Name (Legal Business Name): WILLIAM CHESTER FORD JR. NP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2006
Last Update Date: 08/06/2025
Certification Date: 08/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1124006200 829 CHIEF EDDIE HOFFMAN HWY
BETHEL AK
99559
US

IV. Provider business mailing address

5555 E PAMELA DR
WASILLA AK
99654-0552
US

V. Phone/Fax

Practice location:
  • Phone: 907-543-6430
  • Fax:
Mailing address:
  • Phone: 706-498-2361
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN144697
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number121442
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: