Provider Demographics
NPI:1841266863
Name:WILLETT, WILLIAM FRANK III (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:FRANK
Last Name:WILLETT
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:203 INDIGO DR
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31525-6865
Mailing Address - Country:US
Mailing Address - Phone:912-261-2669
Mailing Address - Fax:912-261-0561
Practice Address - Street 1:2122 MANCHESTER EXPY
Practice Address - Street 2:DEPT OF PATHOLOGY
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-6878
Practice Address - Country:US
Practice Address - Phone:706-596-4100
Practice Address - Fax:706-596-4112
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2019-08-15
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Provider Licenses
StateLicense IDTaxonomies
GA047174207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA220031645OtherRAILROAD MEDICARE
GA00837955BMedicaid
GA22BDCXSMedicare PIN