Provider Demographics
NPI:1366562183
Name:SEARE, WILLIAM JOHN JR (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:JOHN
Last Name:SEARE
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:5770 S 250 E STE 235
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-6191
Mailing Address - Country:US
Mailing Address - Phone:801-262-5552
Mailing Address - Fax:801-262-5771
Practice Address - Street 1:5770 S 250 E STE 235
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-6191
Practice Address - Country:US
Practice Address - Phone:801-262-5552
Practice Address - Fax:801-262-5771
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT158049-12052086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTD07351Medicare UPIN