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Individual

WILLIAM P PANNELL JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
416 A 4TH AVE E, CORDELE, GA 31015
(229) 273-9050
(229) 276-3641
Mailing address
416 E 4TH AVE STE A, CORDELE, GA 31015-3729
(229) 273-9050
(229) 276-3641

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
15713
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00119523B
GA
05
00119523F
GA
05
00119523G
GA
Enumeration date
02/06/2006
Last updated
11/10/2014
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