Provider Demographics
NPI:1326293440
Name:WILLIAM J BRIGGS MD PC
Entity Type:Organization
Organization Name:WILLIAM J BRIGGS MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:BRIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:MDPC
Authorized Official - Phone:229-868-6467
Mailing Address - Street 1:144 E OAK ST
Mailing Address - Street 2:P. O. BOX 466
Mailing Address - City:MC RAE
Mailing Address - State:GA
Mailing Address - Zip Code:31055-4338
Mailing Address - Country:US
Mailing Address - Phone:229-868-6467
Mailing Address - Fax:229-868-5900
Practice Address - Street 1:144 E OAK ST
Practice Address - Street 2:
Practice Address - City:MC RAE
Practice Address - State:GA
Practice Address - Zip Code:31055-4338
Practice Address - Country:US
Practice Address - Phone:229-868-6467
Practice Address - Fax:229-868-5900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-18
Last Update Date:2011-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA207Q00000XOtherTAXONOMY NUMBER
GA000008016AMedicaid
GA1063513729OtherNPI INDIVIDUAL NUMBER
GA207Q00000XOtherTAXONOMY NUMBER
GA000008016AMedicaid