Provider Demographics
NPI:1235172628
Name:NASH, WILLIAM DONATHAN (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:DONATHAN
Last Name:NASH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 626
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31639-0626
Mailing Address - Country:US
Mailing Address - Phone:229-686-3129
Mailing Address - Fax:229-543-1006
Practice Address - Street 1:1225 E MCPHERSON AVE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:GA
Practice Address - Zip Code:31639-2370
Practice Address - Country:US
Practice Address - Phone:229-686-3129
Practice Address - Fax:229-543-1006
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2010-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA37630207P00000X
GA037630207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00626161BMedicaid
GA506609OtherBC/BS GEORGIA
GA000626161BOtherPEACHSTATE
GA000626161BOtherPEACHSTATE
GA00626161BMedicaid