Provider Demographics
NPI:1891067658
Name:DR. BILL'S KIDS, PC
Entity Type:Organization
Organization Name:DR. BILL'S KIDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:DINSMORE
Authorized Official - Last Name:SHILLING
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:478-934-2874
Mailing Address - Street 1:426 GA HIGHWAY 26 E
Mailing Address - Street 2:
Mailing Address - City:COCHRAN
Mailing Address - State:GA
Mailing Address - Zip Code:31014-2837
Mailing Address - Country:US
Mailing Address - Phone:478-934-2874
Mailing Address - Fax:478-934-2876
Practice Address - Street 1:426 GA HIGHWAY 26 E
Practice Address - Street 2:
Practice Address - City:COCHRAN
Practice Address - State:GA
Practice Address - Zip Code:31014-2837
Practice Address - Country:US
Practice Address - Phone:478-934-2874
Practice Address - Fax:478-934-2876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-08
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA47841208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000943445CMedicaid