MEDICARE: DR. WILLIAM D SHILLING III MD

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	208000000X	Pediatrics Physician	047841	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639177140
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM D SHILLING III MD

Provider Business Mailing Address
First Line	:	426 GA HIGHWAY 26 E
Second Line	:
City	:	COCHRAN
State	:	GA
Zip	:	31014-2837
Country	:	US
Telephone Number	:	478-934-2874
Fax Number	:	478-934-2876

Provider Business Practice Location Address
First Line	:	426 GA HIGHWAY 26 E
Second Line	:
City	:	COCHRAN
State	:	GA
Zip	:	31014-2837
Country	:	US
Telephone Number	:	478-934-2874
Fax Number	:	478-934-2876

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

Provider Enumeration Date	:	07/08/2005
Last Update Date	:	10/04/2011

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Directions to “ DR. WILLIAM D SHILLING III MD” Practice Location

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