Provider Demographics
NPI:1558141424
Name:DEBERRY, BILLY DON III
Entity Type:Individual
Prefix:MR
First Name:BILLY
Middle Name:DON
Last Name:DEBERRY
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 COUNTY ROAD 840
Mailing Address - Street 2:
Mailing Address - City:GAYLESVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35973-2156
Mailing Address - Country:US
Mailing Address - Phone:256-630-4162
Mailing Address - Fax:
Practice Address - Street 1:304 TURNER MCCALL BLVD SW
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30165-5621
Practice Address - Country:US
Practice Address - Phone:706-509-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-29
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant