Individual
ROGER ALAN WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
655 FIRST STREET, MACON, GA 31201
(478) 301-5930
(478) 301-5932
Mailing address
1550 COLLEGE ST, A, MACON, GA 31207-0001
(478) 301-5930
(478) 301-5932
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY001108
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000342933A
—
GA
01
—
680006605
RAILROAD MEDICARE
GA
Enumeration date
10/19/2006
Last updated
10/30/2014
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