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NPI Code Detail

MEDICARE: CHADWICK G SILLS JR. DPT

MEDICARE:   CHADWICK G SILLS JR. DPT
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
1225100000XPhysical TherapistPT7950MS

General Provider Information

NPI Number : 1861385718
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHADWICK G SILLS JR. DPT
Provider Business Mailing Address
First Line : 921 W BEACON ST
Second Line :
City : PHILADELPHIA
State : MS
Zip : 39350-3229
Country : US
Telephone Number : 601-650-0002
Fax Number :
Provider Business Practice Location Address
First Line : 102 W RAILROAD AVE N
Second Line :
City : CRYSTAL SPRINGS
State : MS
Zip : 39059-2154
Country : US
Telephone Number : 601-647-9010
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/30/2025
Last Update Date : 05/30/2025

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Directions to “ CHADWICK G SILLS JR. DPT” Practice Location

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