Provider Demographics
NPI:1861910127
Name:DISHMAN, WILLIAM ALAN (OD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:ALAN
Last Name:DISHMAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7000 PARADISE RD APT 1131
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-4495
Mailing Address - Country:US
Mailing Address - Phone:415-218-6763
Mailing Address - Fax:
Practice Address - Street 1:7000 PARADISE RD APT 1131
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-4495
Practice Address - Country:US
Practice Address - Phone:415-218-6763
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV945152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist