William P Pannell Jr., MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

15713 Issued in GA

Practice address

416 A 4TH Ave E
Cordele, GA 31015

Phone

(229) 273-9050

Fax

(229) 276-3641

NPI assigned

Feb 6, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: william.pannell@crispregional.gadirect.net

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1139184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415577600000",
    "number": "1689646457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 E 4TH AVE STE A",
            "city": "CORDELE",
            "state": "GA",
            "postal_code": "310153729",
            "telephone_number": "229-273-9050",
            "fax_number": "229-276-3641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 A 4TH AVE E",
            "city": "CORDELE",
            "state": "GA",
            "postal_code": "31015",
            "telephone_number": "229-273-9050",
            "fax_number": "229-276-3641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANNELL",
        "first_name": "WILLIAM",
        "middle_name": "P",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-06",
        "last_updated": "2014-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "15713",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00119523G",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00119523B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00119523F",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael R. Nulph, M.D.
• Kevin Obregon, PHARMACIST
• Pristella Ohanaja, FNP-C
• Marcus Evans Overstreet, DC
• Sumer Shaye Overstreet, FNP
• Joni Parkerson
• Carrie Lyn Parson, RNCPNP
• Susan Patel, PHARM D
• Taylor M Pearson, MED, CCC-SLP
• Claudeshia Pertilla, CCC-SLP

• Surgery Physician in Cordele, GA
• Providers in Cordele, GA by specialty
• Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.