Healthcare Provider Details

I. General information

NPI: 1083716658
Provider Name (Legal Business Name): WILLIAM HARANT DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2006
Last Update Date: 05/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6554 E CARONDELET DR
TUCSON AZ
85710-2117
US

IV. Provider business mailing address

6554 E CARONDELET DR
TUCSON AZ
85710-2117
US

V. Phone/Fax

Practice location:
  • Phone: 520-886-5311
  • Fax: 520-886-2969
Mailing address:
  • Phone: 520-886-5311
  • Fax: 520-886-2969

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number288
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: