Provider Demographics
NPI:1285678185
Name:BIKOFF, WILLIAM S (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:S
Last Name:BIKOFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:300 PRIME PT STE 101
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269-6851
Mailing Address - Country:US
Mailing Address - Phone:770-486-7195
Mailing Address - Fax:770-486-9414
Practice Address - Street 1:300 PRIME PT STE 101
Practice Address - Street 2:
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-6851
Practice Address - Country:US
Practice Address - Phone:770-486-7195
Practice Address - Fax:770-486-9414
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0194842084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00151038AMedicaid
GA100140OtherBCBS
GAAB8107117OtherDEA
GA00151038AMedicaid