Selvidge, William Scott

Selvidge, William Scott is an sole proprietor health care provider with primary practice located at 608 Broadway Ave , Mattoon IL 61938-4321. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Selvidge, William Scott can be contacted via phone (217) 235-4664.

Contact Information

Primary practice address
608 Broadway Ave Mattoon IL 61938-4321
Phone: (217) 235-4664
Fax: (217) 235-2100
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X 038-008622 Illinois

Profile Details

NPI number 1841347812
LBN Legal business name Selvidge, William Scott
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 4th, 2007
Last updated Aug 19th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1841347812 NPPES
Illinois MEDICAID 038008622
Illinois Other 44-03304
Illinois Other 06022634
Illinois Other 9086460
Illinois Other 407016

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