Individual
WILLIAM C. CHISHOLM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
163 S TALLAHASSEE ST, HAZLEHURST, GA 31539-6465
(912) 375-7781
(912) 375-4055
Mailing address
PO BOX 1839, THOMSON, GA 30824-5839
(706) 466-1751
(706) 597-9621
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
033291
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00512564AA
—
GA
Enumeration date
01/04/2006
Last updated
08/07/2007
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