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Individual

WILLIAM JASON SQUIRES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
AA-C

Contact information

Practice address
1364 CLIFTON RD NE, ATLANTA, GA 30322-1059
(404) 778-3900
Mailing address
5620 SEMINOLE WAY, ACWORTH, GA 30102-5948
(770) 573-1781

Taxonomy

Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
GA

Other

Enumeration date
08/08/2008
Last updated
08/08/2008
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