Provider Demographics
NPI:1992898530
Name:MACKILLIGAN, WILLIAM JOSEPH (RPH)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:JOSEPH
Last Name:MACKILLIGAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MOLLYS RUN
Mailing Address - Street 2:
Mailing Address - City:KENNEBUNK
Mailing Address - State:ME
Mailing Address - Zip Code:04043-7768
Mailing Address - Country:US
Mailing Address - Phone:207-985-0981
Mailing Address - Fax:
Practice Address - Street 1:331 VERANDA ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04103-5545
Practice Address - Country:US
Practice Address - Phone:800-322-0280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPR0002929183500000X
NHRR1155183500000X
MA15540183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist