Organization Name: | WAINSCOTT WALK-IN MEDICAL CARE PLLC |
NPI Number: | 1952513566 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | WILLIAM BLAKELEY KERR (OWNER) |
Mailing Address: | 83 Wainscott Northwest Road Wainscott |
State: | NY US |
Postal Code: | 119752003 |
Phone Number: | 6315371892 |
Fax Number: | 6315373053 |
NPI Enumeration Date: | 05/04/2007 |
NPI Last Update Date: | 02/23/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |