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NPI Code Detail

MEDICARE: MR. GEORGE NORMAN WILLIAMS III CRNA

MEDICARE: MR. GEORGE NORMAN WILLIAMS III CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WC1500XCommunity Health Registered NurseRN162229GA
2367500000XCertified Registered Nurse AnesthetistRN162229GA

General Provider Information

NPI Number : 1043298003
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. GEORGE NORMAN WILLIAMS III CRNA
Provider Business Mailing Address
First Line : 7315 RAND DR
Second Line :
City : DOUGLASVILLE
State : GA
Zip : 30135-5605
Country : US
Telephone Number : 210-722-5983
Fax Number :
Provider Business Practice Location Address
First Line : 80 JESSE HILL JR DR SE
Second Line :
City : ATLANTA
State : GA
Zip : 30303-3050
Country : US
Telephone Number : 404-616-5519
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2006
Last Update Date : 12/15/2020

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