Provider Demographics
NPI:1861683526
Name:PREUNINGER, BILLY DARREN (MD)
Entity Type:Individual
Prefix:
First Name:BILLY
Middle Name:DARREN
Last Name:PREUNINGER
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 1:3780 US HIGHWAY 17
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:GA
Mailing Address - Zip Code:31324-3378
Mailing Address - Country:US
Mailing Address - Phone:912-756-2292
Mailing Address - Fax:912-756-2289
Practice Address - Street 1:3780 US HIGHWAY 17
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:GA
Practice Address - Zip Code:31324-3378
Practice Address - Country:US
Practice Address - Phone:912-756-2292
Practice Address - Fax:912-756-2289
Is Sole Proprietor?:No
Enumeration Date:2007-08-07
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA064446207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
1762424OtherCIGNA
GA697002675DMedicaid
GA624565OtherWELLCARE
GAP00853755OtherRR MEDICARE
GA697002675CMedicaid
GA564159OtherWELLCARE - RICHMOND HILL OFFICE
GA697002675BMedicaid
GA564165OtherWELLCARE - SAVH OFFICE
SCGA1101Medicaid
GA697002675AMedicaid
GA697002675EMedicaid
GA697002675BMedicaid