Healthcare Provider Details

I. General information

NPI: 1912989781
Provider Name (Legal Business Name): WILLIAM HENDERSON MCCRAY JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2005
Last Update Date: 04/16/2025
Certification Date: 04/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3825 MEDICAL PARK DR STE 100
AUSTELL GA
30106-6831
US

IV. Provider business mailing address

2841 DEBARR ROAD SUITE 50
ANCHORAGE AK
99508-2932
US

V. Phone/Fax

Practice location:
  • Phone: 470-267-1760
  • Fax:
Mailing address:
  • Phone: 907-276-2811
  • Fax: 907-276-2810

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number4314
License Number StateAK
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number100754
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: