Provider Demographics
NPI:1255308557
Name:TAUNTON, WILLIAM STEPHEN SR (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:STEPHEN
Last Name:TAUNTON
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:120 N LEE ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:FORSYTH
Mailing Address - State:GA
Mailing Address - Zip Code:31029-2122
Mailing Address - Country:US
Mailing Address - Phone:478-994-0437
Mailing Address - Fax:478-994-6787
Practice Address - Street 1:120 N LEE ST
Practice Address - Street 2:SUITE A
Practice Address - City:FORSYTH
Practice Address - State:GA
Practice Address - Zip Code:31029-2122
Practice Address - Country:US
Practice Address - Phone:478-994-0437
Practice Address - Fax:478-994-6787
Is Sole Proprietor?:No
Enumeration Date:2006-03-06
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA020903207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000211307EMedicaid
D30982Medicare UPIN
GA000211307EMedicaid