Individual
MR. JOHN RICHARD WILLIAMS I
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
189 BO JAMES ST STE 105, CLAYTON, GA 30525-6199
(706) 782-0016
(706) 782-0180
Mailing address
189 BO JAMES ST STE 105, CLAYTON, GA 30525-6199
(706) 782-0016
(706) 782-0180
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-13479
NC
363A00000X
Physician Assistant
Primary
7425
GA
363A00000X
Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
007425
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003153646G
—
GA
05
—
003153646H
—
GA
05
—
003153646I
—
GA
05
—
003153646J
—
GA
05
—
003153646K
—
GA
05
—
003153646L
—
GA
01
—
06705493
AMERIGROUP
GA
01
—
1819077
WELLCARE
GA
Enumeration date
11/10/2014
Last updated
06/05/2024
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