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NPI Code Detail

MEDICARE: DR. WILLIAM T BOYETT JR. M.D.

MEDICARE: DR. WILLIAM T BOYETT JR. M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician048758GA
2207Q00000XFamily Medicine PhysicianE3239ZGA
3207QA0401XAddiction Medicine (Family Medicine) Physician048758GA

General Provider Information

NPI Number : 1053366286
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WILLIAM T BOYETT JR. M.D.
Provider Business Mailing Address
First Line : 914 VISTA DRIVE
Second Line :
City : DALTON
State : GA
Zip : 30721-8654
Country : US
Telephone Number : 706-226-3139
Fax Number : 706-278-6606
Provider Business Practice Location Address
First Line : 914 VISTA DRIVE
Second Line :
City : DALTON
State : GA
Zip : 30721-8654
Country : US
Telephone Number : 706-226-3139
Fax Number : 706-278-6606
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2006
Last Update Date : 08/19/2024

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