| Doctor Name: | DR. WILLIAM COLLAZO-NUNEZ |
| NPI Number: | 1881776201 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 008209 |
| Business Practice Address: | Usa Meddac, Rwbahc 2240 E. Winrow Ave., Attn: Mcxj-credentials Fort Huachuca, AZ - 856137079 |
| Business Phone Number: | 5205991696 |
| Business Fax Number: | 5205337099 |
| Mailing Address: | 1933 Exeter Dr, SIERRA VISTA |
| State: | AZ |
| Postal Code: | 856354817 |
| Phone Number: | 5204583445 |
| Fax Number: | |
| NPI Enumeration Date: | 10/19/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 171000000X |
| License Number: | 008209 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Military Health Care Provider |
| Taxonomy Specialization: | |
| Taxonomy Definition: | Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |