Healthcare Provider Details

I. General information

NPI: 1154378891
Provider Name (Legal Business Name): WILLIAM J ARTZ JR. D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2006
Last Update Date: 07/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9821 ACADEMY RD
PHILADELPHIA PA
19114-1545
US

IV. Provider business mailing address

9821 ACADEMY RD
PHILADELPHIA PA
19114-1545
US

V. Phone/Fax

Practice location:
  • Phone: 215-632-8700
  • Fax: 215-632-5901
Mailing address:
  • Phone: 215-632-8700
  • Fax: 215-632-5901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS005288L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: