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General NPI Number Information
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NPI Number | 1548440183
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Entity Type | Organization
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Legal Business Name | WILLIAM T. MIYAZAKI, D.O., PC
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Dates
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Enumeration Date | 11/12/2007
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Last Update Date | 08/08/2022
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Provider Practice Location Address
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Address Line | 5990 SILVER LAKE RD
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City | RENO
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State | NV
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Zip | 89506-2301
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Country | US
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Telephone | 775-972-9100
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Fax | 775-972-9101
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Provider Business Mailing Address
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Address Line | 5990 SILVER LAKE RD
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City | RENO
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State | NV
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Zip | 89506-2301
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Country | US
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Telephone | 775-972-9100
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Fax | 775-972-9101
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. WILLIAM T, MIYAZAKI
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Credential | DO
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Telephone | 775-972-9100
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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 | 447
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License Number State | NV
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