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Individual

WILLIAM A. EYZAGUIRRE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5677 BUFORD HWY NE, STE. 210, DORAVILLE, GA 30340-1244
(678) 547-1045
(678) 547-1048
Mailing address
PO BOX 769609, ROSWELL, GA 30076-8224
(770) 730-5800
(770) 730-5803

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
014243
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000111966D
GA
05
000111966E
GA
05
000111966G
GA
05
000111966H
GA
Enumeration date
06/06/2006
Last updated
07/07/2010
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