Doctor Name: | WILLIAM BARTON MAHAN |
NPI Number: | 1578899555 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | HAS-BC 1808 |
License Number: | 264554716 |
Business Practice Address: | 10601 Us Highway 441 Ste E1 Leesburg, FL - 347887240 |
Business Phone Number: | 3523600023 |
Business Fax Number: | 3523600013 |
Mailing Address: | 10601 Us Highway 441, Suite E-1 LEESBURG |
State: | FL |
Postal Code: | 347887237 |
Phone Number: | 3523600023 |
Fax Number: | 3523600013 |
NPI Enumeration Date: | 10/26/2009 |
NPI Last Update Date: | 02/09/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 264554716 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |