Provider Demographics
NPI:1407883374
Name:HARTIGAN, WILLIAM JOSEPH JR (DPM)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:JOSEPH
Last Name:HARTIGAN
Suffix:JR
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02474-2251
Mailing Address - Country:US
Mailing Address - Phone:781-646-6564
Mailing Address - Fax:781-777-1904
Practice Address - Street 1:31 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02474-2251
Practice Address - Country:US
Practice Address - Phone:781-646-6564
Practice Address - Fax:781-777-1904
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-27
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1724213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0361011Medicaid
MA33857OtherHCHP
MAY70768OtherBCBS
MA719870OtherTUFTS HEALTH PLAN
MA056409001OtherDMEMACA
MAY70768Medicare PIN