Healthcare Provider Details

I. General information

NPI: 1649290479
Provider Name (Legal Business Name): WILLIAM CAYPLESS PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 06/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

76 COUNTY ROAD 64 SUITE 3
WOODLAND AL
36280-5209
US

IV. Provider business mailing address

119 AMBULANCE DR SUITE 202
CARROLLTON GA
30117-3857
US

V. Phone/Fax

Practice location:
  • Phone: 256-449-2001
  • Fax: 256-449-2174
Mailing address:
  • Phone: 256-449-2001
  • Fax: 256-449-2174

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA105
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: