Provider Demographics
NPI:1194960245
Name:FAUGHT, WILLIAM ERNEST JR (SA-C)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:ERNEST
Last Name:FAUGHT
Suffix:JR
Gender:M
Credentials:SA-C
Other - Prefix:
Other - First Name:
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Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5155 E EAGLE DR UNIT 20730
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85277-3031
Mailing Address - Country:US
Mailing Address - Phone:804-337-4530
Mailing Address - Fax:
Practice Address - Street 1:4320 E PRESIDIO ST STE 101
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85215-1165
Practice Address - Country:US
Practice Address - Phone:804-337-4530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-03
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant