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Individual

WILLIAM W BAXLEY JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
818 FORSYTH STREET, MACON, GA 31201-2139
(478) 633-7010
(478) 633-7585
Mailing address
P.O. BOX 28170, MACON, GA 31221-8170
(478) 254-5943
(478) 254-6093

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
014029
GA
207Y00000X
Otolaryngology Physician
Primary
14029
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00093651C
GA
01
P00024532
RR MEDICARE
GA
Enumeration date
10/16/2006
Last updated
01/11/2011
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