Individual
SAMUEL GREGORY WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
1040 DIVISION ST, MAUSTON, WI 53948-1931
(608) 847-5000
Mailing address
1040 DIVISION ST, MAUSTON, WI 53948-1931
(608) 847-5000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
363
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42939400
—
WI
Enumeration date
09/30/2005
Last updated
07/16/2007
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