Provider Demographics
NPI:1831178649
Name:MORRISSEY, WILLIAM MICHAEL JR (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:MICHAEL
Last Name:MORRISSEY
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 1:1213 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HELLERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18055-1320
Mailing Address - Country:US
Mailing Address - Phone:610-838-7638
Mailing Address - Fax:610-838-7669
Practice Address - Street 1:1213 MAIN ST
Practice Address - Street 2:
Practice Address - City:HELLERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18055-1320
Practice Address - Country:US
Practice Address - Phone:610-838-7638
Practice Address - Fax:610-838-7669
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-10
Last Update Date:2011-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD058803L2086S0122X, 208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA50081760OtherCAPITAL BLUE CROSS
PA20008760OtherAMERIHEALTH MERCY
PA929456OtherHEALTH AMERICA
PA0016697270005Medicaid
PA3549318000OtherPERSONAL CHOICE
PA50081760OtherKEYSTONE HEALTH PLAN CENTRAL
PA77823OtherGEISINGER HEALTH PLAN
PA1313736OtherHIGHMARK BLUE SHIELD
PA5399899OtherCIGNA
PA6636390OtherAETNA
PA50081760OtherKEYSTONE SENIOR BLUE
PAP3955099OtherOXFORD
PA3549318000OtherKEYSTONE HEALTH PLAN EAST
PA1579038OtherGATEWAY
PA823539OtherFIRST PRIORITY
PA929456OtherHEALTH ASSURANCE
PA823539OtherFIRST PRIORITY