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General NPI Number Information
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NPI Number | 1992863062
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Entity Type | Organization
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Legal Business Name | WILLIAM MAHON, MD PC
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Dates
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Enumeration Date | 12/04/2006
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Last Update Date | 10/19/2011
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Provider Practice Location Address
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Address Line | 140 W 6TH ST SUITE 210
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City | OSWEGO
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State | NY
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Zip | 13126-2525
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Country | US
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Telephone | 315-343-3992
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Fax | 315-343-1455
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Provider Business Mailing Address
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Address Line | 140 W 6TH ST SUITE 210
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City | OSWEGO
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State | NY
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Zip | 13126-2525
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Country | US
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Telephone | 315-343-3992
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Fax | 315-343-1455
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. WILLIAM A MAHON
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Credential | MD
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Telephone | 315-343-3992
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 1423231
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License Number State | NY
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