Provider Demographics
NPI:1982867685
Name:NICHOLSON, WILLIAM LANIER (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:LANIER
Last Name:NICHOLSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:563 OAK RIDGE DRIVE
Mailing Address - Street 2:
Mailing Address - City:HIAWASSEE
Mailing Address - State:GA
Mailing Address - Zip Code:30546-2224
Mailing Address - Country:US
Mailing Address - Phone:706-896-2832
Mailing Address - Fax:706-896-2832
Practice Address - Street 1:563 OAK RIDGE DRIVE
Practice Address - Street 2:
Practice Address - City:HIAWASSEE
Practice Address - State:GA
Practice Address - Zip Code:30546-2224
Practice Address - Country:US
Practice Address - Phone:706-896-2832
Practice Address - Fax:706-896-2832
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-03
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GAGA8845207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine