MEDICARE: MR. WILLIAM CHESTER FORD JR. NP-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	363LF0000X	Family Nurse Practitioner	RN144697	GA
2	363LF0000X	Family Nurse Practitioner	121442	AK

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	:	1124006200
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. WILLIAM CHESTER FORD JR. NP-C

Provider Business Mailing Address
First Line	:	5555 E PAMELA DR
Second Line	:
City	:	WASILLA
State	:	AK
Zip	:	99654-0552
Country	:	US
Telephone Number	:	706-498-2361
Fax Number	:

Provider Business Practice Location Address
First Line	:	1124006200
Second Line	:	829 CHIEF EDDIE HOFFMAN HWY
City	:	BETHEL
State	:	AK
Zip	:	99559
Country	:	US
Telephone Number	:	907-543-6430
Fax Number	:

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

Provider Enumeration Date	:	01/09/2006
Last Update Date	:	08/06/2025

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