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General NPI Number Information
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NPI Number | 1558564658
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Entity Type | Individual
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Provider Name | WILLIAM CHAD STATTON M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/06/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 710 NEWNAN CROSSING BYP STE 200
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City | NEWNAN
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State | GA
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Zip | 30263-2384
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Country | US
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Telephone | 530-477-4480
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Fax | 530-477-4499
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Provider Business Mailing Address
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Address Line | 710 NEWNAN CROSSING BYP STE 200
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City | NEWNAN
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State | GA
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Zip | 30263-2384
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Country | US
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Telephone | 678-423-7860
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | A111162
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 01064072A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 41092
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License Number State | KY
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Taxonomy #4
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 01064072A
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License Number State | IN
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Taxonomy #5
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 41092
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License Number State | KY
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Taxonomy #6
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 077941
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License Number State | GA
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