Provider Demographics
NPI:1255517892
Name:WARD, WILLIAM TATE (CRNA)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:TATE
Last Name:WARD
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
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Mailing Address - Street 1:227 MOUNTAIN DRIVE
Mailing Address - Street 2:
Mailing Address - City:DAHLONEGA
Mailing Address - State:GA
Mailing Address - Zip Code:30533
Mailing Address - Country:US
Mailing Address - Phone:706-867-4116
Mailing Address - Fax:706-867-4120
Practice Address - Street 1:227 MOUNTAIN DR
Practice Address - Street 2:
Practice Address - City:DAHLONEGA
Practice Address - State:GA
Practice Address - Zip Code:30533-1606
Practice Address - Country:US
Practice Address - Phone:706-867-4116
Practice Address - Fax:706-867-4120
Is Sole Proprietor?:No
Enumeration Date:2008-01-14
Last Update Date:2010-03-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GARN193888367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered