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General NPI Number Information
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NPI Number | 1659952174
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Entity Type | Individual
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Provider Name | WILLIAM GRADY NOLAN JR. MD
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Gender | Male
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Dates
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Enumeration Date | 04/16/2021
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Last Update Date | 07/07/2025
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Provider Practice Location Address
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Address Line | 2230 STOCKTON BLVD
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City | SACRAMENTO
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State | CA
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Zip | 95817-1353
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Country | US
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Telephone | 916-734-2614
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Fax |
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Provider Business Mailing Address
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Address Line | 3901 RAINBOW BLVD # MS 4015
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City | KANSAS CITY
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State | KS
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Zip | 66160-8500
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Country | US
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Telephone | 913-588-6400
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Fax | 913-588-6414
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 333636
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 95-00023
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License Number State | KS
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Taxonomy #3
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Taxonomy Code | 2084F0202X
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Taxonomy Name | Forensic Psychiatry Physician
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License Number | A200938
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License Number State | CA
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