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General NPI Number Information
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NPI Number | 1780621318
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Entity Type | Individual
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Provider Name | WILLIAM H SOUTHWICK M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/01/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2222 CENTRE ST DEUTSCHES ALTENHEIM GERMAN CTR
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City | WEST ROXBURY
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State | MA
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Zip | 02132-4034
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Country | US
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Telephone | 617-325-1230
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Fax |
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Provider Business Mailing Address
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Address Line | 256 BUNN DR SUITE #6
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City | PRINCETON
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State | NJ
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Zip | 08540-2859
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Country | US
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Telephone | 617-325-1230
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 208346
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License Number State | MA
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