Organization Active NPI

William W. Tung MD P.C.

  • Neurology Physician
  • Dallas, GA
National Provider Identifier
1861705196
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
053409 Issued in GA
Legal business name
WILLIAM W. TUNG MD P.C.
Practice address
2713 Charles Hardy Pkwy Ste 221
Dallas, GA 30157-9470
Phone
(678) 501-5420
Fax
(678) 501-5427
NPI assigned
Jul 15, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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

Authorized official

Name
Dr. William W Tung, MDNPI 1154345205
Title
Physician
Phone
(770) 953-3603

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X 053409 GA Primary

Addresses

Primary practice location

2713 Charles Hardy Pkwy Ste 221
Dallas, GA 30157-9470

Mailing address

1770 High TRL
Atlanta, GA 30339-5617
Phone (770) 953-3603

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20101025001146 GA Part B Supplier - Clinic/Group Practice 4082807854 Receives reassigned benefits from 1 practitioner
Practice locations: Atlanta, GA; Dallas, GA; Douglasville, GA
O20240424001409 GA DME Supplier - Physician - Neurology 4082807854 Practice locations: Dallas, GA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

4904 Timber Ridge Dr
Ste 305
Douglasville, GA 30135
Phone (678) 501-5420

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1279152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733184000000",
    "number": "1861705196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1770 HIGH TRL",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303395617",
            "telephone_number": "770-953-3603",
            "fax_number": "470-787-2178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2713 CHARLES HARDY PKWY STE 221",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301579470",
            "telephone_number": "678-501-5420",
            "fax_number": "678-501-5427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM W. TUNG MD P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-15",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A",
        "authorized_official_last_name": "TUNG",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "770-953-3603",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "GA",
            "license": "053409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.