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General NPI Number Information
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NPI Number | 1003837469
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Entity Type | Individual
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Provider Name | WILLIAM KINLAW M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/21/2006
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 455 SAINT MICHAELS DR
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City | SANTA FE
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State | NM
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Zip | 87505-7601
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Country | US
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Telephone | 505-983-3361
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2505
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City | SALEM
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State | OR
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Zip | 97308-2505
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Country | US
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Telephone | 888-828-3197
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 97-293
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License Number State | NM
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