Individual
MR. JERROD LAQUINTON WILLIAMS SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSA
Contact information
Practice address
207 ARABELLA PKWY, LOCUST GROVE, GA 30248-4250
(404) 932-0295
Mailing address
PO BOX 420429, ATLANTA, GA 30342-0429
(404) 932-0295
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
2610
GA
Other
Enumeration date
03/07/2007
Last updated
05/03/2026
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