Individual
WAYNE WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
284 HIGHWAY 314 STE E, FAYETTEVILLE, GA 30214-7832
(770) 964-0611
(770) 964-0608
Mailing address
284 HIGHWAY 314 STE E, FAYETTEVILLE, GA 30214-7832
(770) 964-0611
(770) 964-0608
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
25070
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000272379Y
—
GA
01
—
009989195
ALABAMA MEDICAID
AL
01
—
196692
BLUE CROSS
GA
01
—
P00202509
RAILROAD MEDICARE
—
Enumeration date
06/26/2006
Last updated
08/19/2024
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