Individual
WILLIAM ALEXANDER LEATHERWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
777 HEMLOCK ST, MACON, GA 31201-2102
(478) 633-1000
Mailing address
598 3RD ST, MACON, GA 31201-3357
(478) 633-6706
(478) 633-5384
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN106774
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000913866A
—
GA
05
—
000913866C
—
GA
05
—
00913866B
—
GA
01
—
430076991
MCRB RAILROAD
GA
Enumeration date
02/20/2006
Last updated
11/26/2008
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