Individual
MR. REGINALD A WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
113 COLONIAL WAY, JESUP, GA 31545-0245
(912) 427-9169
(912) 427-9171
Mailing address
PO BOX 467, JESUP, GA 31598-0467
(912) 427-9169
(912) 427-9171
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
055788
GA
208600000X
Surgery Physician
37487
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64061377
—
KY
Enumeration date
11/07/2006
Last updated
10/08/2013
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