Provider Demographics
NPI:1164467577
Name:LIKINS, WILLIAM BLAINE III (DC)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:BLAINE
Last Name:LIKINS
Suffix:III
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 TRINITY CT
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-5264
Mailing Address - Country:US
Mailing Address - Phone:434-525-4588
Mailing Address - Fax:434-525-4514
Practice Address - Street 1:1084 THOMAS JEFFERSON RD
Practice Address - Street 2:UNIT 12
Practice Address - City:FOREST
Practice Address - State:VA
Practice Address - Zip Code:24551-2275
Practice Address - Country:US
Practice Address - Phone:434-525-4588
Practice Address - Fax:434-525-4514
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104555971111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA461938OtherANTHEM BC/BS
VA350001202Medicare ID - Type Unspecified
VA461938OtherANTHEM BC/BS