Individual
DR. WILLIAM I WALLER III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1211 COLUMBIA DR, MILLEDGEVILLE, GA 31061
(478) 452-1780
(478) 452-1786
Mailing address
1211 COLUMBIA DR, MILLEDGEVILLE, GA 31061
(478) 452-1780
(478) 452-1786
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
017899
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
017899
STATE LISCENCE
GA
Enumeration date
07/07/2006
Last updated
02/16/2010
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