Basic Information
| Provider Information | |||||||||
| NPI: | 1477648558 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LAYMAN | ||||||||
| FirstName: | WILLIAM | ||||||||
| MiddleName: | D | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1602 | ||||||||
| Address2: | |||||||||
| City: | DALTON | ||||||||
| State: | GA | ||||||||
| PostalCode: | 30720 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7062710100 | ||||||||
| FaxNumber: | 7062700487 | ||||||||
| Practice Location | |||||||||
| Address1: | 106 MEDICAL CENTER BLVD | ||||||||
| Address2: | |||||||||
| City: | FAYETTEVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 373342684 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8664579896 | ||||||||
| FaxNumber: | 7062262283 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/04/2006 | ||||||||
| LastUpdateDate: | 06/21/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | MD0000014812 | TN | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
ID Information
| ID | Type | State | Issuer | Description | P00152908 | 01 | TN | RAILROAD MEDICARE | OTHER | 3894413 | 05 | TN | MEDICAID |