Provider Demographics
NPI:1821062985
Name:DEMPSEY, WILLIAM JR (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:DEMPSEY
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 PAMELA DR
Mailing Address - Street 2:
Mailing Address - City:CLARKS SUMMIT
Mailing Address - State:PA
Mailing Address - Zip Code:18411-9712
Mailing Address - Country:US
Mailing Address - Phone:570-840-2252
Mailing Address - Fax:
Practice Address - Street 1:1145 NORTHERN BLVD
Practice Address - Street 2:
Practice Address - City:SOUTH ABINGTON TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:18411-2221
Practice Address - Country:US
Practice Address - Phone:570-585-1300
Practice Address - Fax:570-230-0013
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD032293E207P00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001085030Medicaid
PA0010850300004Medicaid
PA0010850300013Medicaid
PA0010850300014Medicaid
PAC34314Medicare UPIN
PA001085030Medicaid
PA452410Medicare PIN