Provider Demographics
NPI:1558564658
Name:STATTON, WILLIAM CHAD (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:CHAD
Last Name:STATTON
Suffix:
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 1:710 NEWNAN CROSSING BYP STE 200
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30263-2384
Mailing Address - Country:US
Mailing Address - Phone:678-423-7860
Mailing Address - Fax:
Practice Address - Street 1:710 NEWNAN CROSSING BYP STE 200
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30263-2384
Practice Address - Country:US
Practice Address - Phone:530-477-4480
Practice Address - Fax:530-477-4499
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA111162208600000X
IN01064072A208600000X, 2086S0129X
KY41092208600000X, 2086S0129X
GA077941208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYP00448647OtherRAILROAD MEDICARE
IN630980IOtherMEDICARE
KY33514OtherMEDICAIRE ID
KY611059472OtherDART
KY000000530699OtherANTHEM
IN200899360Medicaid
611059472OtherUMWA
KY7100020120Medicaid
KY7100020120Medicaid