Provider Demographics
NPI:1255388823
Name:PARHAM, WILLIAM W (DO)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:W
Last Name:PARHAM
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1027
Mailing Address - Street 2:
Mailing Address - City:FITZGERALD
Mailing Address - State:GA
Mailing Address - Zip Code:31750-1027
Mailing Address - Country:US
Mailing Address - Phone:229-426-7685
Mailing Address - Fax:229-426-7627
Practice Address - Street 1:808 S GRANT ST
Practice Address - Street 2:
Practice Address - City:FITZGERALD
Practice Address - State:GA
Practice Address - Zip Code:31750-3703
Practice Address - Country:US
Practice Address - Phone:229-424-7685
Practice Address - Fax:229-424-7627
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA46468207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA16BDSXGMedicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
GAH01160Medicare UPIN