Provider Demographics
NPI:1457375560
Name:MEGGINSON, WILLIAM JAY (PT)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:JAY
Last Name:MEGGINSON
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7048 JEWETT STREET
Mailing Address - Street 2:P.O. BOX 866
Mailing Address - City:MONTROSE
Mailing Address - State:AL
Mailing Address - Zip Code:36559
Mailing Address - Country:US
Mailing Address - Phone:251-929-3646
Mailing Address - Fax:
Practice Address - Street 1:7048 JEWETT STREET
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:AL
Practice Address - Zip Code:36559-0866
Practice Address - Country:US
Practice Address - Phone:251-929-3646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH3138174400000X
225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL510-02125OtherBCBS
AL890013700Medicaid
AL510-02125OtherBCBS
AL510I650146Medicare PIN