Provider Demographics
NPI:1871717322
Name:CONRAN, WILLIAM VICTOR SR (MD)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:VICTOR
Last Name:CONRAN
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3495 LAKESIDE DR # 123
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-4841
Mailing Address - Country:US
Mailing Address - Phone:775-626-1159
Mailing Address - Fax:775-322-5642
Practice Address - Street 1:1155 MILL ST
Practice Address - Street 2:RENOWN
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1576
Practice Address - Country:US
Practice Address - Phone:775-626-1159
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2015-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3625208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV2016061Medicaid
NV2016061Medicaid