Individual
TINA V WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6330 PRIMROSE HILL CT, NORCROSS, GA 30092-4544
(770) 903-0134
(770) 903-0135
Mailing address
PO BOX 769609, ROSWELL, GA 30076-8224
(770) 903-0134
(770) 903-0135
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036040
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000731959A
—
GA
01
—
1609816123
GEORGIA CLINIC, PC GROUP NPI #
GA
Enumeration date
05/30/2006
Last updated
02/17/2016
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