Healthcare Provider Details

I. General information

NPI: 1801932983
Provider Name (Legal Business Name): WILLIAM E. FIKE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 04/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

232 19TH ST NW SUITE 7220
ATLANTA GA
30363-1130
US

IV. Provider business mailing address

PO BOX 102321
ATLANTA GA
30368-2321
US

V. Phone/Fax

Practice location:
  • Phone: 404-367-3000
  • Fax: 404-609-7628
Mailing address:
  • Phone: 770-801-2500
  • Fax: 770-803-2121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number071710
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: