Provider Demographics
NPI:1699576900
Name:GRANT, WILLIAM III
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:GRANT
Suffix:III
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14885 PEYTON DR
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:AL
Mailing Address - Zip Code:35613-2680
Mailing Address - Country:US
Mailing Address - Phone:256-795-7705
Mailing Address - Fax:
Practice Address - Street 1:14885 PEYTON DR
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:AL
Practice Address - Zip Code:35613-2680
Practice Address - Country:US
Practice Address - Phone:256-795-7705
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-22
Last Update Date:2025-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician