Provider Demographics
NPI:1073546099
Name:MACNAMARA, WILLIAM PATRICK III (DC)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:PATRICK
Last Name:MACNAMARA
Suffix:III
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 WAUREGAN RD
Mailing Address - Street 2:
Mailing Address - City:DANIELSON
Mailing Address - State:CT
Mailing Address - Zip Code:06239-3717
Mailing Address - Country:US
Mailing Address - Phone:860-779-9870
Mailing Address - Fax:860-779-9872
Practice Address - Street 1:138 WAUREGAN RD
Practice Address - Street 2:
Practice Address - City:DANIELSON
Practice Address - State:CT
Practice Address - Zip Code:06239-3717
Practice Address - Country:US
Practice Address - Phone:860-779-9870
Practice Address - Fax:860-779-9872
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT00962111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT350000717Medicare PIN