Provider Demographics
NPI:1033499595
Name:DIAMOND, WILLIAM H JR (PA-C)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:H
Last Name:DIAMOND
Suffix:JR
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:4566 E HIGHWAY 20 STE 101
Mailing Address - Street 2:
Mailing Address - City:NICEVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32578-8839
Mailing Address - Country:US
Mailing Address - Phone:850-897-7546
Mailing Address - Fax:
Practice Address - Street 1:4566 E HIGHWAY 20 STE 101
Practice Address - Street 2:
Practice Address - City:NICEVILLE
Practice Address - State:FL
Practice Address - Zip Code:32578-8839
Practice Address - Country:US
Practice Address - Phone:850-897-7546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-27
Last Update Date:2021-08-16
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant