MEDICARE: WILLIAM EUGENE WILLIAMS LCSW

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
1	1041C0700X	Clinical Social Worker	001694	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871567693
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM EUGENE WILLIAMS LCSW

Provider Business Mailing Address
First Line	:	PO BOX 7737
Second Line	:
City	:	WARNER ROBINS
State	:	GA
Zip	:	31095-7737
Country	:	US
Telephone Number	:	478-923-3762
Fax Number	:	478-923-0362

Provider Business Practice Location Address
First Line	:	1047 N HOUSTON RD
Second Line	:
City	:	WARNER ROBINS
State	:	GA
Zip	:	31093-1505
Country	:	US
Telephone Number	:	478-923-3762
Fax Number	:	478-923-0362

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/16/2006
Last Update Date	:	05/22/2008

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