Provider Demographics
NPI:1780666719
Name:MAYFIELD, WILLIAM RODGER (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:RODGER
Last Name:MAYFIELD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:61 WHITCHER ST NE
Mailing Address - Street 2:SUITE 4120
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-1176
Mailing Address - Country:US
Mailing Address - Phone:770-424-9732
Mailing Address - Fax:770-421-0228
Practice Address - Street 1:61WHITCHER ST NE
Practice Address - Street 2:SUITE 4120
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-1155
Practice Address - Country:US
Practice Address - Phone:770-424-9732
Practice Address - Fax:770-421-0228
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2019-09-27
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Provider Licenses
StateLicense IDTaxonomies
GA035105208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00367639BMedicaid
GAD65737Medicare UPIN
GA33BDBGJMedicare ID - Type Unspecified