Provider Demographics
NPI:1356365225
Name:DELP, WILLIAM A JR (DO)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:A
Last Name:DELP
Suffix:JR
Gender:M
Credentials:DO
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Mailing Address - Street 1:625 OLD PEACHTREE RD NW
Mailing Address - Street 2:SUITE 104
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-2937
Mailing Address - Country:US
Mailing Address - Phone:678-225-7485
Mailing Address - Fax:678-225-7489
Practice Address - Street 1:625 OLD PEACHTREE RD NW
Practice Address - Street 2:SUITE 104
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-2937
Practice Address - Country:US
Practice Address - Phone:678-225-7485
Practice Address - Fax:678-225-7489
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2016-03-08
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Provider Licenses
StateLicense IDTaxonomies
GA017791207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA235941OtherBLUE CROSS BLUE SHEILD
GAGRP692OtherMEDICARE GROUP
GAGRP692OtherMEDICARE GROUP
GAD39725Medicare UPIN