Individual
DR. WILLIAM LESLIE HORNBACK IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1007 GREENFIELD DR, TIFTON, GA 31794-3795
(229) 382-9733
Mailing address
907 18TH ST E STE 400, TIFTON, GA 31794-3684
(229) 382-9733
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
066548
GA
208600000X
Surgery Physician
57010975
OH
Other
Enumeration date
03/21/2007
Last updated
12/01/2020
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