Provider Demographics
NPI:1982882999
Name:WIDDOWSON, H. DOUGLAS (M ED OF AUDIOLOGY)
Entity Type:Individual
Prefix:MR
First Name:H.
Middle Name:DOUGLAS
Last Name:WIDDOWSON
Suffix:
Gender:M
Credentials:M ED OF AUDIOLOGY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 N 17TH ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-5034
Mailing Address - Country:US
Mailing Address - Phone:610-439-1196
Mailing Address - Fax:610-434-2200
Practice Address - Street 1:401 N 17TH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-5034
Practice Address - Country:US
Practice Address - Phone:610-439-1196
Practice Address - Fax:610-434-2200
Is Sole Proprietor?:No
Enumeration Date:2008-02-01
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT 000096L231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAWI 205998Medicare PIN