Provider Demographics
NPI:1124634381
Name:BEGUHN, WILLIAM C
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:C
Last Name:BEGUHN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4530 BRAYDEN DR
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30504-9233
Mailing Address - Country:US
Mailing Address - Phone:706-870-2402
Mailing Address - Fax:
Practice Address - Street 1:3130 ATLANTA HWY
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-6977
Practice Address - Country:US
Practice Address - Phone:706-715-6236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-22
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH032113183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist