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Contact Information

WILLIAM G MALLON, CRNA
2149 FOUND LAKE RD. BOX 625
SAINT GERMAIN, WI54558-0625
 Phone: 715-542-2728
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nurse Anesthetist, Certified Registered

367500000X 43 Certified Registered Nurse Anesthetist (CRNA)
Indicates primary specialty

NPI Profile & details for WILLIAM G MALLON · (Male)

NPI Number 1013090885
Status Active
Credentials CRNA (Certified Registered Nurse Anesthetist)
Entity Individual
Enumeration date 10/23/2006
Last updated 03/22/2010 - About 10 years ago
Sole proprietor 1 Yes
Identifiers
  • IN License # 28182298A
  • MI License # 470412917
  • WI License # 137583-030
  • IN Medicaid 200929030
  • Other 026511 AANA/CRNA
  • IN Other 000000602388 ANTHEM PROVIDER NUMBER
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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