Provider Demographics
NPI:1902881485
Name:MCCALL, WILLIAM VAUGHN (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:VAUGHN
Last Name:MCCALL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1120 15TH ST
Mailing Address - Street 2:STE BI1056
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30912-0004
Mailing Address - Country:US
Mailing Address - Phone:706-828-8401
Mailing Address - Fax:706-722-7235
Practice Address - Street 1:997 ST. SEBASTIAN WAY
Practice Address - Street 2:GEORGIA REGENTS MEDICAL ASSOCIATES
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30901
Practice Address - Country:US
Practice Address - Phone:706-721-6597
Practice Address - Fax:706-721-6602
Is Sole Proprietor?:No
Enumeration Date:2005-12-07
Last Update Date:2019-07-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA0677332084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003123754AMedicaid
GA067733OtherMEDICAL LICENSE
NC29335OtherMEDICAL LICENSE
SC36407OtherMEDICAL LICENSE
SCQ29335OtherSC MEDICAID
GA202I262619 -Medicare UPIN