Provider Demographics
NPI:1558354076
Name:GEORGE, WILLIAM MOSE JR (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:MOSE
Last Name:GEORGE
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2701 MEREDYTH DR
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31707-2267
Mailing Address - Country:US
Mailing Address - Phone:229-883-7010
Mailing Address - Fax:229-435-4022
Practice Address - Street 1:2701 MEREDYTH DR
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31707-2267
Practice Address - Country:US
Practice Address - Phone:229-883-7010
Practice Address - Fax:229-435-4022
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA012125207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00015133AMedicaid
D45423Medicare UPIN