Organization
DR JERRY V WILLIAMS A PROFESSIONAL MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JERRY V. WILLIAMS M. D. (OWNER)
(225) 647-9297
Entity
Organization
Contact information
Practice address
317 W ASCENSION ST, GONZALES, LA 70737-2805
(225) 647-9297
(225) 647-3784
Mailing address
317 W ASCENSION ST, GONZALES, LA 70737-2805
(225) 647-9297
(225) 647-3784
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
017104
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1347353
—
LA
Enumeration date
07/05/2007
Last updated
06/26/2008
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