Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | 23975 | GA |
NPI | 1003819467 |
---|---|
Provider Name | William A Guest |
First Address | Tifton, GA 31794-3648 |
Second Address | Tifton, GA 31794-3648 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2005 |
Last Update Date | 18/06/2015 |