Provider Demographics
NPI:1235402819
Name:PARHAM, WILLIAM HAROLD SR (CRNA)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:HAROLD
Last Name:PARHAM
Suffix:SR
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 VINSON RD
Mailing Address - Street 2:
Mailing Address - City:MC INTYRE
Mailing Address - State:GA
Mailing Address - Zip Code:31054-2091
Mailing Address - Country:US
Mailing Address - Phone:478-946-2640
Mailing Address - Fax:
Practice Address - Street 1:1135 CARTHAGE ST
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-4162
Practice Address - Country:US
Practice Address - Phone:919-774-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-13
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC97167367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered