Brazil, William W
Brazil, William W is an individual health care provider with primary practice located at 100 Mimosa Dr , Thomasville GA 31792-6676. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Brazil, William W can be contacted via phone (229) 226-9141.Contact Information
Primary practice address
100 Mimosa Dr
Thomasville GA 31792-6676
Phone: (229) 226-9141
Fax: (229) 228-0637
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | GA001990 | Georgia |
Profile Details
| NPI number | 1184696759 |
|---|---|
| LBN Legal business name | Brazil, William W |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 7th, 2006 |
| Last updated | Apr 22nd, 2019 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1184696759 | NPPES |
| Georgia | Other | 302656 | WELLCARE |
| Georgia | MEDICAID | 100001302A | WELLCARE |
| Georgia | Other | 100001302A | WELLCARE |
| Georgia | Other | 970009975 | WELLCARE |
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