Organization
WOODSTOCK PEDIATRICS PC
Active
Other names
Main Street Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIMBERLY T WILLIAMS M.D. (M.D.)
(706) 632-0330
Entity
Organization
Contact information
Practice address
460 W MAIN ST, SUITE 100, BLUE RIDGE, GA 30513-7127
(706) 632-0330
(706) 632-9004
Mailing address
460 W MAIN ST, SUITE 100, BLUE RIDGE, GA 30513-7127
(706) 632-0330
(706) 632-9004
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
032063
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000448269F
—
GA
Enumeration date
09/10/2009
Last updated
01/31/2011
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