William Gunther Mallon, CRNA is a
Nurse Anesthetist, Certified Registered based in Saint Germain, Wisconsin. William Gunther Mallon is licensed to practice in Indiana (license number 28182298A) and his current practice location is
2149 Found Lake Rd. Box 625, Saint Germain, Wisconsin. He can be reached at his office (for appointments etc.) via phone at
(715) 542-2728.
NPI number for William Gunther Mallon is 1013090885 and his current mailing address is Po Box 625, Saint Germain, Wisconsin. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1013090885.
Provider's Profile
| Full Name | William Gunther Mallon |
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| Gender | Male |
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| Speciality | Nurse Anesthetist, Certified Registered |
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| Location | 2149 Found Lake Rd. Box 625, Saint Germain, Wisconsin |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1013090885
- Provider Enumeration Date: 10/23/2006
- Last Update Date: 03/22/2010
Medical Identifiers
Medical identifiers for William Gunther Mallon such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1013090885 | NPI | - | NPPES |
| 000000602388 | Other | IN | ANTHEM PROVIDER NUMBER |
| 026511 | Other | | AANA/CRNA |
| 200929030 | Medicaid | IN | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 137583-030 (Wisconsin) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | 470412917 (Michigan) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | 28182298A (Indiana) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. William Gunther Mallon is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
William Gunther Mallon, CRNA
Po Box 625,
Saint Germain, WI 54558-0625
Ph: (715) 542-2728 | William Gunther Mallon, CRNA
2149 Found Lake Rd. Box 625,
Saint Germain, WI 54558-0625
Ph: (715) 542-2728 |
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