Healthcare Provider Details

I. General information

NPI: 1134998636
Provider Name (Legal Business Name): WILLIAM PATRICK SCYPHERS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/26/2023
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2727 PACES FERRY RD SE STE 500
ATLANTA GA
30339-4053
US

IV. Provider business mailing address

2727 PACES FERRY RD SE STE 500
ATLANTA GA
30339-4053
US

V. Phone/Fax

Practice location:
  • Phone: 470-853-6444
  • Fax:
Mailing address:
  • Phone: 470-851-6444
  • Fax: 256-582-3216

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: