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NPI Code Detail

MEDICARE: DR. WILLIAM J MORAN M.D.

MEDICARE: DR. WILLIAM J MORAN M.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
1207Y00000XOtolaryngology PhysicianMD25018OR
2207Y00000XOtolaryngology Physician036-070119IL
3207Y00000XOtolaryngology Physician49189WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1972500718
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WILLIAM J MORAN M.D.
Provider Business Mailing Address
First Line : 1000 N OAK AVE
Second Line :
City : MARSHFIELD
State : WI
Zip : 54449-5703
Country : US
Telephone Number : 715-387-5511
Fax Number :
Provider Business Practice Location Address
First Line : 3501 CRANBERRY BLVD
Second Line :
City : WESTON
State : WI
Zip : 54476-5213
Country : US
Telephone Number : 715-393-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2005
Last Update Date : 07/26/2011

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Directions to “ DR. WILLIAM J MORAN M.D.” Practice Location

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