Basic Information
| Provider Information | |||||||||
| NPI: | 1962455758 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KITTLE | ||||||||
| FirstName: | WILLIAM | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 820 SAINT SEBASTIAN WAY | ||||||||
| Address2: | SUITE 5C | ||||||||
| City: | AUGUSTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 309012643 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7067745995 | ||||||||
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| Practice Location | |||||||||
| Address1: | 820 SAINT SEBASTIAN WAY | ||||||||
| Address2: | SUITE 5C | ||||||||
| City: | AUGUSTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 309012643 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7067745995 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/19/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0200X | 025197 | GA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine |
No ID Information.