Basic Information
Provider Information
NPI: 1689668485
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PEKARSKE
FirstName: WILLIAM
MiddleName: J
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 645 E MISSOURI AVE
Address2: STE 300
City: PHOENIX
State: AZ
PostalCode: 850121351
CountryCode: US
TelephoneNumber: 6022628900
FaxNumber: 6022628890
Practice Location
Address1: 3390 N CAMPBELL AVE
Address2: STE 110
City: TUCSON
State: AZ
PostalCode: 857192380
CountryCode: US
TelephoneNumber: 5207957650
FaxNumber: 5203251622
Other Information
ProviderEnumerationDate: 09/07/2005
LastUpdateDate: 02/13/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/13/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X26555AZY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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