Healthcare Provider Details

I. General information

NPI: 1619908050
Provider Name (Legal Business Name): WILLIAM L. FLOOD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 03/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HWY 191 & HOSPITAL ROAD CCHCF
CHINLE AZ
86503
US

IV. Provider business mailing address

PO BOX PH
CHINLE AZ
86503-8000
US

V. Phone/Fax

Practice location:
  • Phone: 928-674-7166
  • Fax: 928-674-7705
Mailing address:
  • Phone: 928-674-7166
  • Fax: 928-674-7705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number18789
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: