Organization
AMSOL PHYSICIANS OF SUPPLY NC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY C WILLIAMS MD (PRESIDENT)
(910) 755-8121
Entity
Organization
Contact information
Practice address
1 MEDICAL CENTER DRIVE, SUPPLY, NC 28462-3350
(910) 755-8121
Mailing address
1 MEDICAL CENTER DR, SUPPLY, NC 28462-3350
(910) 755-8121
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016HG
BLUE SHIELD
NC
05
—
89016HG
—
NC
01
—
DC6604
RR MEDICARE
NC
Enumeration date
10/11/2006
Last updated
08/22/2020
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