Organization
INTEGRATED WOUND SPECIALISTS OF ELIZABETH, LLC
Active
Parent organization
DIVERSIFIED CLINICAL SERVICES
Organization subpart
Yes
Provider details
NPI number
Legal business name
DIVERSIFIED CLINICAL SERVICES
Authorized official
FRANK WILLIAMS (CEO)
(904) 446-3519
Entity
Organization
Contact information
Practice address
240 WILLIAMSON ST, SUITE 104, ELIZABETH, NJ 07202-3674
(908) 994-5480
(908) 994-8802
Mailing address
PO BOX 848591, BOSTON, MA 02284-8591
(904) 446-3451
(904) 446-3451
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200454
GROUP MEDICARE PTAN
NJ
Enumeration date
05/25/2010
Last updated
06/01/2023
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