Provider Demographics
NPI:1225080823
Name:SOTACK, WILLIAM E JR (DO)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:E
Last Name:SOTACK
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:WILLIAM
Other - Middle Name:E
Other - Last Name:SOTACK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:801 OSTRUM ST
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18015-1000
Mailing Address - Country:US
Mailing Address - Phone:484-526-4500
Mailing Address - Fax:484-526-6674
Practice Address - Street 1:801 OSTRUM ST
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18015-1000
Practice Address - Country:US
Practice Address - Phone:484-526-4500
Practice Address - Fax:484-526-6674
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2017-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS012288207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1634604OtherHIGHMARK BS
PA1010922150003Medicaid
I14285Medicare UPIN
PA082369L9EMedicare ID - Type Unspecified