MEDICARE: MR. WILLIAM JOSEPH CARLE PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant	432	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003929415
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. WILLIAM JOSEPH CARLE PA-C

Provider Business Mailing Address
First Line	:	120 ETON ST
Second Line	:
City	:	PAHRUMP
State	:	NV
Zip	:	89048-6118
Country	:	US
Telephone Number	:	775-751-2619
Fax Number	:

Provider Business Practice Location Address
First Line	:	2100 E CALVADA BLVD
Second Line	:
City	:	PAHRUMP
State	:	NV
Zip	:	89048-5805
Country	:	US
Telephone Number	:	775-727-7535
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/17/2006
Last Update Date	:	07/08/2007

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