# WILLIAM J RIVERS III MD LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043877269
- **Authorized official:** WILLIAM JACOCKS RIVERS III MD (OWNER)
- **Authorized official phone:** (770) 579-9000

## Contact information

- **Practice address:** 3225 SHALLOWFORD RD STE 500, MARIETTA, GA 30062-7024
- **Practice address phone:** (770) 579-9000
- **Mailing address:** 3225 SHALLOWFORD RD STE 500, MARIETTA, GA 30062-7024
- **Mailing address phone:** (770) 579-9000
- **Mailing address fax:** (888) 844-0784

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/22/2019
- **Last updated:** 08/26/2022