William T Bacon IV, PA-C
NPI #1730181942 in Santa Fe, New Mexico
Provider Information
- NPI Number
- 1730181942
- Entity Type
- Individual
- Name
- William T Bacon IV, PA-C
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physician Assistant - Medical
- Credential
- PA-C
- Enumeration Date
- Jun 1, 2005
- Last Updated
- Mar 6, 2025
Practice Location
- Address
- 1650 HOSPITAL DR STE 500
- City
- Santa Fe
- State
- New Mexico
- ZIP Code
- 87505-4794
- Phone
- (505) 670-1976
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant - Medical — Medical |
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