Healthcare Provider Details

I. General information

NPI: 1457375560
Provider Name (Legal Business Name): WILLIAM JAY MEGGINSON PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 11/11/2022
Certification Date: 11/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7048 JEWETT STREET
MONTROSE AL
36559-0866
US

IV. Provider business mailing address

7048 JEWETT STREET P.O. BOX 866
MONTROSE AL
36559
US

V. Phone/Fax

Practice location:
  • Phone: 251-929-3646
  • Fax:
Mailing address:
  • Phone: 251-929-3646
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberPTH3138
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: