MEDICARE: WILLIAM STRAWN GODFREY M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	291189	MA
2	390200000X	Student in an Organized Health Care Education/Training Program
3	207XS0114X	Adult Reconstructive Orthopaedic Surgery Physician	94987	GA

General Provider Information

NPI Number	:	1316470479
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM STRAWN GODFREY M.D.

Provider Business Mailing Address
First Line	:	75 FRANCIS ST
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02115-6110
Country	:	US
Telephone Number	:	912-306-4595
Fax Number	:

Provider Business Practice Location Address
First Line	:	1150 HAMMOND DR STE 400
Second Line	:
City	:	SANDY SPRINGS
State	:	GA
Zip	:	30328-8617
Country	:	US
Telephone Number	:	770-762-1786
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/06/2017
Last Update Date	:	05/10/2023

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