Provider Demographics
NPI:1982648788
Name:LAY, WILLIAM RANDALL III (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:RANDALL
Last Name:LAY
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:284 EXECUTIVE PARK DR
Mailing Address - Street 2:STE 100
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-1831
Mailing Address - Country:US
Mailing Address - Phone:704-633-3616
Mailing Address - Fax:704-939-1173
Practice Address - Street 1:405 NC 65
Practice Address - Street 2:
Practice Address - City:REIDSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27320
Practice Address - Country:US
Practice Address - Phone:704-633-3616
Practice Address - Fax:704-939-1173
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2023-11-27
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Provider Licenses
StateLicense IDTaxonomies
NC311632084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
28532Medicare UPIN
2233486Medicare ID - Type Unspecified