Healthcare Provider Details

I. General information

NPI: 1801893409
Provider Name (Legal Business Name): WILLIAM DONALD HOISINGTON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2005
Last Update Date: 01/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3225 I-70 BUSINESS LOOP STE A4
CLIFTON CO
81520-7687
US

IV. Provider business mailing address

3225 I-70 BUSINESS LOOP STE A4
CLIFTON CO
81520-7687
US

V. Phone/Fax

Practice location:
  • Phone: 970-434-6542
  • Fax: 970-434-3327
Mailing address:
  • Phone: 970-434-6542
  • Fax: 970-434-3327

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number24942
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: