Provider Demographics
NPI:1124006200
Name:FORD, WILLIAM CHESTER JR (NP-C)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:CHESTER
Last Name:FORD
Suffix:JR
Gender:M
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5555 E PAMELA DR
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-0552
Mailing Address - Country:US
Mailing Address - Phone:706-498-2361
Mailing Address - Fax:
Practice Address - Street 1:1124006200
Practice Address - Street 2:829 CHIEF EDDIE HOFFMAN HWY
Practice Address - City:BETHEL
Practice Address - State:AK
Practice Address - Zip Code:99559
Practice Address - Country:US
Practice Address - Phone:907-543-6430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN144697363LF0000X
AK121442363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA346968043AMedicaid
GA346968043AMedicaid
GAQ23994Medicare UPIN