Provider Demographics
NPI:1912939794
Name:DOERHOFF, WILLIAM SCOTT (MS PT)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:SCOTT
Last Name:DOERHOFF
Suffix:
Gender:M
Credentials:MS PT
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 7265
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72217-7265
Mailing Address - Country:US
Mailing Address - Phone:501-920-8465
Mailing Address - Fax:
Practice Address - Street 1:400 STUTTGART HWY
Practice Address - Street 2:
Practice Address - City:ENGLAND
Practice Address - State:AR
Practice Address - Zip Code:72046-2440
Practice Address - Country:US
Practice Address - Phone:501-842-2771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2010-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1482225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR145592721Medicaid
AR5W927Medicare ID - Type Unspecified