Provider Demographics
NPI:1396853990
Name:PARTIN, WILLIAM CLYDE JR (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:CLYDE
Last Name:PARTIN
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:1365 CLIFTON RD NE
Mailing Address - Street 2:A3418
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30322-4200
Mailing Address - Country:US
Mailing Address - Phone:404-778-0480
Mailing Address - Fax:404-778-2890
Practice Address - Street 1:1365 CLIFTON RD NE
Practice Address - Street 2:A3418
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-4200
Practice Address - Country:US
Practice Address - Phone:404-778-0480
Practice Address - Fax:404-778-2890
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2012-01-26
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Provider Licenses
StateLicense IDTaxonomies
GA026612207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F34824Medicare UPIN