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Individual

JOHNNY WILLIAMS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2121A BELLEVUE RD, DUBLIN, GA 31021-2998
(478) 272-1190
(478) 274-7628
Mailing address
2121A BELLEVUE RD, DUBLIN, GA 31021-2998
(478) 272-1190
(478) 274-7628

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
194363
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
300030912A
GA
Enumeration date
07/02/2014
Last updated
07/02/2014
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