Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | 63081 | GA |
N | 208200000X | Surgeon | L-228120 | MA |
N | 208600000X | Surgeon | L-228120 | MA |
NPI | 1598892952 |
---|---|
Provider Name | William H. Kitchens JR. |
First Address | Atlanta, GA 30322-0001 |
Second Address | Atlanta, GA 30322-1059 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2007 |
Last Update Date | 30/01/2014 |