Provider Demographics
NPI:1902029598
Name:WILLIAM R. ATKINS JR., M.D.
Entity Type:Organization
Organization Name:WILLIAM R. ATKINS JR., M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:ROGER
Authorized Official - Last Name:ATKINS
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:302-633-4525
Mailing Address - Street 1:PO BOX 10504
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19850-0504
Mailing Address - Country:US
Mailing Address - Phone:302-540-9186
Mailing Address - Fax:302-777-0944
Practice Address - Street 1:550 STANTON CHRISTIANA RD
Practice Address - Street 2:SUITE 201
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2198
Practice Address - Country:US
Practice Address - Phone:302-633-4525
Practice Address - Fax:302-633-4461
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC100043882081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE52791Medicare UPIN
DE424388Medicare ID - Type Unspecified