MEDICARE: WILLIAM HALLMON MD

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
1	207RG0100X	Gastroenterology Physician	31123	WI
2	207RG0100X	Gastroenterology Physician	61783	GA

General Provider Information

NPI Number	:	1780603555
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM HALLMON MD

Provider Business Mailing Address
First Line	:	1497 FAIR RD STE 104
Second Line	:
City	:	STATESBORO
State	:	GA
Zip	:	30458-0822
Country	:	US
Telephone Number	:	912-486-1600
Fax Number	:	912-871-3342

Provider Business Practice Location Address
First Line	:	1497 FAIR RD STE 102
Second Line	:
City	:	STATESBORO
State	:	GA
Zip	:	30458-0823
Country	:	US
Telephone Number	:	912-486-1600
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	08/17/2023

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Directions to “ WILLIAM HALLMON MD” Practice Location

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