Individual
WILLIAM J. PANERAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
961 E WINTHROPE AVE, MILLEN, GA 30442-1839
(706) 294-2196
(678) 819-0357
Mailing address
PO BOX 529, ROYSTON, GA 30662-0529
(706) 621-7575
(706) 621-7557
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
004211
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
449873228C
—
GA
05
—
449873228D
—
GA
05
—
449873228E
—
GA
05
—
449873228F
—
GA
05
—
449873228G
—
GA
05
—
449873228H
—
GA
Enumeration date
09/22/2006
Last updated
08/26/2016
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