Provider Demographics
NPI:1861705196
Name:WILLIAM W. TUNG MD P.C.
Entity type:Organization
Organization Name:WILLIAM W. TUNG MD P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:W
Authorized Official - Last Name:TUNG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-953-3603
Mailing Address - Street 1:1770 HIGH TRL
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-5617
Mailing Address - Country:US
Mailing Address - Phone:770-953-3603
Mailing Address - Fax:470-787-2178
Practice Address - Street 1:2713 CHARLES HARDY PKWY STE 221
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:GA
Practice Address - Zip Code:30157-9470
Practice Address - Country:US
Practice Address - Phone:678-501-5420
Practice Address - Fax:678-501-5427
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-15
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0534092084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA6883999343AMedicaid
GA6883999343AMedicaid