Healthcare Provider Details

I. General information

NPI: 1467437574
Provider Name (Legal Business Name): WILLIAM WARNER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/12/2005
Last Update Date: 07/25/2023
Certification Date: 07/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6070 S FORT APACHE RD STE 100
LAS VEGAS NV
89148-5615
US

IV. Provider business mailing address

6070 S FORT APACHE RD STE 100
LAS VEGAS NV
89148-5615
US

V. Phone/Fax

Practice location:
  • Phone: 702-803-5534
  • Fax: 409-419-1108
Mailing address:
  • Phone: 702-803-5534
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number21265
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code207PE0005X
TaxonomyUndersea and Hyperbaric Medicine (Emergency Medicine) Physician
License NumberJ9932
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberJ9932
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: