Organization
SOUTHWEST SURGICAL ASSOCIATES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. REGINALD ANTONIO WILLIAMS M. D. (SURGEON)
(404) 354-1983
Entity
Organization
Contact information
Practice address
311 PEACHTREE ST, JESUP, GA 31545-0245
(912) 427-9169
(912) 427-9171
Mailing address
PO BOX 467, JESUP, GA 31598-0467
(912) 427-9169
(912) 427-9171
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64061377
—
GA
Enumeration date
07/28/2010
Last updated
04/27/2012
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