Healthcare Provider Details

I. General information

NPI: 1346172160
Provider Name (Legal Business Name): WILLIAM P DOUD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 S 4TH ST
AMES IA
50011-1142
US

IV. Provider business mailing address

1800 S 4TH ST
AMES IA
50011-1142
US

V. Phone/Fax

Practice location:
  • Phone: 515-249-3662
  • Fax:
Mailing address:
  • Phone: 515-924-3662
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: