Healthcare Provider Details

I. General information

NPI: 1558065342
Provider Name (Legal Business Name): WILLIAM STALLINGS DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2023
Last Update Date: 05/23/2026
Certification Date: 05/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4A DEVINE ST
NORTH HAVEN CT
06473-2142
US

IV. Provider business mailing address

4A DEVINE ST
NORTH HAVEN CT
06473-2142
US

V. Phone/Fax

Practice location:
  • Phone: 203-287-6920
  • Fax:
Mailing address:
  • Phone: 203-287-6920
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number1209
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: