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NPI Code Detail

MEDICARE: DR. WILLIAM A DELP JR. DO

MEDICARE: DR. WILLIAM A DELP JR. DO
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
1207Q00000XFamily Medicine Physician017791GA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2GRP692OTHERGAMEDICARE GROUP

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1235941OTHERGABLUE CROSS BLUE SHEILD

General Provider Information

NPI Number : 1356365225
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WILLIAM A DELP JR. DO
Provider Business Mailing Address
First Line : 625 OLD PEACHTREE RD NW
Second Line : SUITE 104
City : SUWANEE
State : GA
Zip : 30024-2937
Country : US
Telephone Number : 678-225-7485
Fax Number : 678-225-7489
Provider Business Practice Location Address
First Line : 625 OLD PEACHTREE RD NW
Second Line : SUITE 104
City : SUWANEE
State : GA
Zip : 30024-2937
Country : US
Telephone Number : 678-225-7485
Fax Number : 678-225-7489
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2006
Last Update Date : 03/08/2016

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Directions to “ DR. WILLIAM A DELP JR. DO” Practice Location

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