Provider Demographics
NPI:1215362702
Name:WILLIAM A CHAFIN III MD PC
Entity Type:Organization
Organization Name:WILLIAM A CHAFIN III MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:A
Authorized Official - Last Name:CHAFIN
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:706-410-9270
Mailing Address - Street 1:961 SMOKY MOUNTAIN SPRINGS LN NE
Mailing Address - Street 2:STE A
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30501-2418
Mailing Address - Country:US
Mailing Address - Phone:678-677-8821
Mailing Address - Fax:678-997-2003
Practice Address - Street 1:1270 PRINCE AVE
Practice Address - Street 2:STE 202
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-2762
Practice Address - Country:US
Practice Address - Phone:706-410-9270
Practice Address - Fax:706-410-9276
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-04
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA67542207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty