# DR JERRY V WILLIAMS A PROFESSIONAL MEDICAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780882290
- **Authorized official:** DR. JERRY V. WILLIAMS M. D. (OWNER)
- **Authorized official phone:** (225) 647-9297

## Contact information

- **Practice address:** 317 W ASCENSION ST, GONZALES, LA 70737-2805
- **Practice address phone:** (225) 647-9297
- **Practice address fax:** (225) 647-3784
- **Mailing address:** 317 W ASCENSION ST, GONZALES, LA 70737-2805
- **Mailing address phone:** (225) 647-9297
- **Mailing address fax:** (225) 647-3784

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 017104 | LA | Yes |

## Other

- **Enumeration date:** 07/05/2007
- **Last updated:** 06/26/2008