Individual
MR. BRANDON W. WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2000 10TH AVE, SUITE 270, COLUMBUS, GA 31901-3700
(706) 571-1011
(706) 320-8646
Mailing address
PO BOX 370, FORTSON, GA 31808-0370
(706) 494-3008
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
PAT9103786
FL
363AM0700X
Medical Physician Assistant
005072
GA
363AS0400X
Surgical Physician Assistant
Primary
005072
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
841278772B
—
GA
Enumeration date
08/31/2006
Last updated
06/08/2020
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