MEDICARE: WILLIAM A LOCY EDD

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	103G00000X	Clinical Neuropsychologist	1659	CO

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760525109
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM A LOCY EDD

Provider Business Mailing Address
First Line	:	1633 FILLMORE ST
Second Line	:	STE 410
City	:	DENVER
State	:	CO
Zip	:	80206-1514
Country	:	US
Telephone Number	:	303-333-4559
Fax Number	:	303-333-0057

Provider Business Practice Location Address
First Line	:	1633 FILLMORE ST
Second Line	:	STE 410
City	:	DENVER
State	:	CO
Zip	:	80206-1514
Country	:	US
Telephone Number	:	303-333-4559
Fax Number	:	303-333-0057

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

Provider Enumeration Date	:	02/15/2007
Last Update Date	:	07/09/2007

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Directions to “ WILLIAM A LOCY EDD” Practice Location

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