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NPI Code Detail

MEDICARE: CYNDI ANDREA WILLIAMS-GREEN PHYSICIANASSISTANT

MEDICARE: CYNDI ANDREA WILLIAMS-GREEN PHYSICIANASSISTANT
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
1363AM0700XMedical Physician Assistant3051GA

General Provider Information

NPI Number : 1205994985
Entity Type Code : Individual
Provider Name (Legal Business Name) : CYNDI ANDREA WILLIAMS-GREEN PHYSICIANASSISTANT
Provider Business Mailing Address
First Line : 229 ELLICOTT DR
Second Line :
City : WARNER ROBINS
State : GA
Zip : 31088-3057
Country : US
Telephone Number : 478-971-7468
Fax Number : 478-825-5499
Provider Business Practice Location Address
First Line : 201 AVERA DR
Second Line :
City : FORT VALLEY
State : GA
Zip : 31030-5008
Country : US
Telephone Number : 478-825-3317
Fax Number : 478-825-5499
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2006
Last Update Date : 07/08/2007

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Directions to “ CYNDI ANDREA WILLIAMS-GREEN PHYSICIANASSISTANT” Practice Location

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