Provider Demographics
NPI:1063801470
Name:GARRY, WILLIAM E (CRNA)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:E
Last Name:GARRY
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 369
Mailing Address - Street 2:
Mailing Address - City:TURNERVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30580-0369
Mailing Address - Country:US
Mailing Address - Phone:706-839-6205
Mailing Address - Fax:706-754-9668
Practice Address - Street 1:541 HISTORIC HWY 441 N
Practice Address - Street 2:
Practice Address - City:DEMOREST
Practice Address - State:GA
Practice Address - Zip Code:30535
Practice Address - Country:US
Practice Address - Phone:706-839-6205
Practice Address - Fax:706-754-9668
Is Sole Proprietor?:No
Enumeration Date:2015-01-22
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN204889367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered