Provider Demographics
NPI:1447461116
Name:CREEL, WILLIAM BRADLEY (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:BRADLEY
Last Name:CREEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1355 PEACHTREE ST NE STE 1600
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-3276
Mailing Address - Country:US
Mailing Address - Phone:404-351-9512
Mailing Address - Fax:404-351-9815
Practice Address - Street 1:1800 HOWELL MILL RD NW
Practice Address - Street 2:SUITE 600
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30318-2538
Practice Address - Country:US
Practice Address - Phone:404-351-9512
Practice Address - Fax:404-351-9815
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2017-10-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MS19896207R00000X
TXN2043207RG0100X
GA65534207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003107583AMedicaid