DR. WILLIAM HAZLE (NPI# 1629039763) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629039763 |
| Entity Type | Individual |
| Full Name | DR. WILLIAM HAZLE |
| Credential | MD |
| Practice Address |
500 S 11th Ave Pocatello ID 83201-4835 |
| Practice Telephone | 9724208345 |
| Practice Fax Number | 9724207770 |
| Mailing Telephone | 9724208345 |
| Mailing Fax Number | 9724207770 |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
M-8594 | ID | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | BC&BS | 50062 | 01 |
| Street Address |
500 S 11TH AVE |
| City | POCATELLO |
| State | ID |
| Zip Code | 83201-4835 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366443699 | Kelli Deanne Christensen | Family Medicine | 500 S 11th Ave, Suite 303, Pocatello, ID 83201 | 2005-08-09 |
| 1700365178 | Adam Gault | Nurse Practitioner | 500 S 11th Ave, Pocatello, ID 83201-4835 | 2018-08-07 |
| 1366982126 | Debra Reiland | Registered Nurse | 500 S 11th Ave, Suite 501, Pocatello, ID 83201-4835 | 2017-02-27 |
| 1235678848 | Jenna Nicole Thompson | Social Worker | 500 S 11th Ave, Suite 303, Pocatello, ID 83201-4835 | 2017-02-15 |
| 1669753109 | Care LLC | Obstetrics & Gynecology | 500 S 11th Ave, Ste 201, Pocatello, ID 83201-4835 | 2011-08-29 |
| 1962790964 | Urology Center of Idaho Pllc | Urology | 500 S 11th Ave, Suite 301, Pocatello, ID 83201-4835 | 2011-07-12 |
| 1689977019 | Karl M Letko | Physician Assistant | 500 S 11th Ave, Suite 503, Pocatello, ID 83201-4835 | 2010-12-07 |
| 1982838694 | Michael Arik Mariska | Counselor | 500 S 11th Ave, Pocatello, ID 83201-4835 | 2009-05-08 |
| 1710111935 | Chelsie Ann Morrison | Family Medicine | 500 S 11th Ave, Suite 102, Pocatello, ID 83201-4835 | 2009-05-04 |
| 1023287828 | Pocatello Children's Clinic | Durable Medical Equipment & Medical Supplies | 500 S 11th Ave, Ste 204, Pocatello, ID 83201-4835 | 2008-02-26 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235765330 | Timothy Palmer | Social Worker | 400 S 11th Ave, Ste 204, Pocatello, ID 83201 | 2020-03-20 |
| 1225687759 | Hanna Percy | Nurse Practitioner | 1151 Hospital Way Ste 201, Pocatello, ID 83201 | 2019-09-07 |
| 1659935195 | Carol Jane Dillon | Counselor | 707 North 7th Avenue, Suite D, Pocatello, ID 83201 | 2019-04-30 |
| 1154801595 | Mv Pocatello Ent, LLC | Otolaryngology | 333 N 18th Ave Ste B3, Pocatello, ID 83201 | 2018-08-15 |
| 1306344346 | Ruth Anne Patton | Social Worker | 850 E Young St, Pocatello, ID 83201 | 2018-01-24 |
| 1598289274 | Lucas Alexander Bryan | Specialist/Technologist | 1535 E Terry St, Pocatello, ID 83201 | 2017-08-03 |
| 1205365632 | Geno Alan Giovanini | Denturist | 115 S. 15th Ave. Ste. D, Pocatello, ID 83201 | 2017-06-08 |
| 1518415942 | Kelli Fries-geslin | Nurse Practitioner | 500 South 11 Ave Suite 400, Pocatello, ID 83201 | 2016-09-14 |
| 1346797842 | Shailyn Jenkins | Specialist/Technologist | 665 Warren Ave., Pocatello, ID 83201 | 2016-09-01 |
| 1992258149 | Christopher Jared White | Social Worker | 300 N 7th Ave, Pocatello, ID 83201 | 2016-07-24 |
| Find all providers in zip 83201 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912046525 | Linda E Carter | Psychiatry & Neurology | 421 Memorial Dr, Pocatello, ID 83201-4008 | 2007-02-06 |
| 1265779078 | Joshua D Smith and Associates Inc | Psychiatry & Neurology | 209 E Lewis St, Pocatello, ID 83201 | 2013-01-14 |
| 1972808806 | Psychiatry-ect, Pllc | Psychiatry & Neurology | 285 Vista Dr, Suite D, Pocatello, ID 83201 | 2011-01-25 |
| 1457499113 | Kathleen Anne Erwin | Psychiatry & Neurology | 777 Hospital Way, Pocatello, ID 83201-5175 | 2007-02-02 |
| 1154431542 | Deric V Ravsten | Psychiatry & Neurology | 1777 E Clark St, Suite 330, Pocatello, ID 83201-3357 | 2006-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811514870 | Ascend LLC | Psychiatry & Neurology | 2001 S Woodruff Ave Ste 9, Idaho Falls, ID 83404-6371 | 2020-06-25 |
| 1770071276 | Michael Duerden | Psychiatry & Neurology | 91 K St, Rexburg, ID 83440-1441 | 2018-04-30 |
| 1528488905 | Alison Joy Krause | Psychiatry & Neurology | 703 South Americana Blvd #150, Boise, ID 83702 | 2014-04-23 |
| 1871912634 | Christine E Birch | Psychiatry & Neurology | 1032 S Bridgeway Pl Ste 110, Eagle, ID 83616 | 2014-04-09 |
| 1750704425 | Rick Dale Turner | Psychiatry & Neurology | 3818 W Catalpa Dr, Boise, ID 83703-4265 | 2014-01-30 |
| 1245670793 | Ashton Memorial, Inc. | Psychiatry & Neurology | 1301 E 17th St Ste 4, Idaho Falls, ID 83404-6273 | 2013-06-28 |
| 1477996932 | Emily Patricia Hutchison | Psychiatry & Neurology | 500 W Fort St Bldg T110, Boise, ID 83702-4501 | 2013-04-14 |
| 1336408632 | Little Angels | Psychiatry & Neurology | 1680 Woodruff Park, Idaho Falls, ID 83401-3330 | 2012-05-08 |
| 1902197007 | Jordan W Merrill | Psychiatry & Neurology | 1032 S. Bridgeway Pl., Ste 110, Eagle, ID 83616 | 2011-04-22 |
| 1730408717 | Kirsten Rose Aaland | Psychiatry & Neurology | 500 W Fort St Bldg 116, Boise, ID 83702-4501 | 2010-05-31 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.