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General NPI Number Information
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NPI Number | 1285626754
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Entity Type | Individual
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Provider Name | WILLIAM L BARTHOLOMEW M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/19/2005
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Last Update Date | 02/04/2025
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Provider Practice Location Address
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Address Line | 1171 W TARGET RANGE RD
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City | NOGALES
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State | AZ
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Zip | 85621-2415
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Country | US
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Telephone | 520-285-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 2202 N FORBES BLVD
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City | TUCSON
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State | AZ
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Zip | 85745-1412
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Country | US
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Telephone | 520-285-3000
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 13614
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License Number State | AZ
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