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General NPI Number Information
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NPI Number | 1154520500
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Entity Type | Organization
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Legal Business Name | WTN GW COURTWRIGHT
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Dates
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Enumeration Date | 07/16/2007
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Last Update Date | 07/16/2007
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Provider Practice Location Address
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Address Line | 3440 HOLLYWOOD BLVD SUITE 460
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City | HOLLYWOOD
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State | FL
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Zip | 33021-6927
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Country | US
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Telephone | 954-923-7440
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Fax | 954-923-1299
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Provider Business Mailing Address
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Address Line | 3440 HOLLYWOOD BLVD SUITE 460
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City | HOLLYWOOD
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State | FL
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Zip | 33021-6927
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Country | US
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Telephone | 954-923-7440
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Fax | 954-923-1299
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Authorized Official
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Title or Position | PROVIDER
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Name | DR. G WILLIAM COURTRIGHT
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Credential | MD
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Telephone | 954-614-3373
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | G44886
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License Number State | CA
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