Individual
ALEX WILLIAM WIDMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RT R VI
Contact information
Practice address
901 N BROAD ST NE, ROME, GA 30161-5201
(706) 291-2661
Mailing address
17 DUBLIN WAY NW, ADAIRSVILLE, GA 30103-3505
(701) 306-4725
Taxonomy
Speciality
Code
Description
License number
State
243U00000X
Radiology Practitioner Assistant
Primary
23RRAGA0213
GA
2471V0106X
Vascular-Interventional Technology Radiologic Technologist
581533
ND
Other
Enumeration date
09/27/2022
Last updated
03/29/2023
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