MEDICARE: MR. WILLIAM HENRY NEWKIRK MSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	089-0000963	VT

General Provider Information

NPI Number	:	1811202823
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. WILLIAM HENRY NEWKIRK MSW

Provider Business Mailing Address
First Line	:	359 DORSET STREET
Second Line	:
City	:	SOUTH BURLINGTON
State	:	VT
Zip	:	05403
Country	:	US
Telephone Number	:	802-862-1806
Fax Number	:	802-865-3319

Provider Business Practice Location Address
First Line	:	359 DORSET ST
Second Line	:
City	:	SOUTH BURLINGTON
State	:	VT
Zip	:	05403-6210
Country	:	US
Telephone Number	:	802-862-1806
Fax Number	:	802-865-3319

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/13/2010
Last Update Date	:	08/13/2010

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