Provider Demographics
NPI:1518960707
Name:HARPER, WILLIAM MADISON IV (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:MADISON
Last Name:HARPER
Suffix:IV
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 1:1021 TALBOTTON RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904-8744
Mailing Address - Country:US
Mailing Address - Phone:706-324-7700
Mailing Address - Fax:706-596-5810
Practice Address - Street 1:1021 TALBOTTON RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-8744
Practice Address - Country:US
Practice Address - Phone:706-324-7700
Practice Address - Fax:706-596-5810
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA020726174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA60103470OtherBCBS ALABAMA
GA00272984EMedicaid
GA52025839OtherBCBS GEORGIA
GA00272984EMedicaid
GA60103470OtherBCBS ALABAMA