Provider Demographics
NPI:1861608887
Name:DR SCOTT D WILLIAMS LLC
Entity type:Organization
Organization Name:DR SCOTT D WILLIAMS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DOCTOR OF CHIROPRACT
Authorized Official - Phone:717-227-2225
Mailing Address - Street 1:16325 MOUNT AIRY ROAD
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:PA
Mailing Address - Zip Code:17361
Mailing Address - Country:US
Mailing Address - Phone:717-227-2225
Mailing Address - Fax:717-227-0784
Practice Address - Street 1:16325 MOUNT AIRY ROAD
Practice Address - Street 2:
Practice Address - City:SHREWSBURY
Practice Address - State:PA
Practice Address - Zip Code:17361
Practice Address - Country:US
Practice Address - Phone:717-227-2225
Practice Address - Fax:717-227-0784
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC006113L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001093Medicare ID - Type Unspecified
U67582Medicare UPIN