MEDICARE: DR. WILLIAM P. BEDELL PH.D.

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	103TC1900X	Counseling Psychologist	1178	AZ

General Provider Information

NPI Number	:	1205811965
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM P. BEDELL PH.D.

Provider Business Mailing Address
First Line	:	2432 W PEORIA AVE STE 1340
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85029-4741
Country	:	US
Telephone Number	:	602-997-1550
Fax Number	:	602-678-0235

Provider Business Practice Location Address
First Line	:	2432 W PEORIA AVE STE 1340
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85029-4741
Country	:	US
Telephone Number	:	602-997-1550
Fax Number	:	602-678-0235

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

Provider Enumeration Date	:	12/14/2005
Last Update Date	:	07/08/2007

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