Individual
MR. WILLIAM THAD POISSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-0004
(630) 750-0771
Mailing address
1120 15TH ST, BA-9431, AUGUSTA, GA 30912-0004
(706) 721-2861
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
RN260182
GA
Other
Enumeration date
07/20/2016
Last updated
01/05/2017
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