Healthcare Provider Details

I. General information

NPI: 1093721730
Provider Name (Legal Business Name): WILLIAM G CANCE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 03/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 N 6TH ST
PHOENIX AZ
85004-2155
US

IV. Provider business mailing address

625 N 6TH ST
PHOENIX AZ
85004-2155
US

V. Phone/Fax

Practice location:
  • Phone: 602-406-8222
  • Fax:
Mailing address:
  • Phone: 602-406-8222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number174011
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number53191
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: