Provider Demographics
NPI:1720427388
Name:COURSON, WILLIAM EANES (DO)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:EANES
Last Name:COURSON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 OAK HILL BLVD
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30265-2313
Mailing Address - Country:US
Mailing Address - Phone:770-304-0987
Mailing Address - Fax:
Practice Address - Street 1:110 OAK HILL BLVD
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265-2313
Practice Address - Country:US
Practice Address - Phone:770-304-0987
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA076800207Q00000X, 207Q00000X, 207Q00000X
NY390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program