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Individual

GREG LEE WILLIAMS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
388 S MAIN ST, BAXLEY, GA 31513-0104
(912) 705-9680
(912) 705-0531
Mailing address
388 S MAIN ST, BAXLEY, GA 31513-0104
(912) 705-9680
(912) 705-0531

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN147732
GA
363LF0000X
Family Nurse Practitioner
RN147732NP
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003120968A
GA
01
202G704612
MEDICARE PTAN
GA
05
812644415J
GA
Enumeration date
09/29/2009
Last updated
07/25/2023
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