Provider Demographics
NPI:1891918561
Name:ATKINS, WILLIAM ROGER JR (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:ROGER
Last Name:ATKINS
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:PO BOX 3837
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:DE
Mailing Address - Zip Code:19807-0837
Mailing Address - Country:US
Mailing Address - Phone:302-777-3955
Mailing Address - Fax:302-777-3956
Practice Address - Street 1:1700 WAWASET ST
Practice Address - Street 2:SUITE 100
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19806-2142
Practice Address - Country:US
Practice Address - Phone:302-777-3955
Practice Address - Fax:302-777-3956
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC100043882081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE424388Medicare ID - Type Unspecified
DEE52791Medicare UPIN