Active NPI
William P Tynan, M.D.
- Public Health & General Preventive Medicine Physician
- Atlanta, GA
National Provider Identifier
1700023397
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health & General Preventive Medicine Physician
- License
- ME 75312
- Practice address
- 1600 Clifton Rd NE
Atlanta, GA 30329-4018 - Phone
- (404) 639-7506
- NPI assigned
- Jan 19, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health & General Preventive Medicine Physician | 2083P0901X | ME 75312 | FL | Primary |
Addresses
Primary practice location
1600 Clifton Rd NE
Atlanta, GA 30329-4018
Mailing address
1600 Clifton Rd NE
Atlanta, GA 30329-4018
Phone (404) 639-7506
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME 75312 | FL | MD | Public Health & General Preventive Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1232323200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1232323200000",
"number": "1700023397",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1600 CLIFTON RD NE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303294018",
"telephone_number": "404-639-7506"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 CLIFTON RD NE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303294018",
"telephone_number": "404-639-7506"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TYNAN",
"first_name": "WILLIAM",
"middle_name": "P",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-01-19",
"last_updated": "2009-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "2083P0901X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Public Health & General Preventive Medicine",
"state": "FL",
"license": "ME 75312",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.