Provider Demographics
NPI:1679520001
Name:FORD, WILLIAM JOSEPH (PA)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:JOSEPH
Last Name:FORD
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1869
Mailing Address - Street 2:
Mailing Address - City:FLETCHER
Mailing Address - State:NC
Mailing Address - Zip Code:28732-1869
Mailing Address - Country:US
Mailing Address - Phone:828-687-6282
Mailing Address - Fax:828-687-6285
Practice Address - Street 1:21 TURTLE CREEK DR
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-3152
Practice Address - Country:US
Practice Address - Phone:828-274-4555
Practice Address - Fax:828-274-8348
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2011-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC100003363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2744812BMedicare PIN