Healthcare Provider Details

I. General information

NPI: 1609286335
Provider Name (Legal Business Name): GEORGE WELDON WILLIAMS II DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2014
Last Update Date: 05/13/2025
Certification Date: 05/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 CARSON ST
JONESBORO AR
72401-3104
US

IV. Provider business mailing address

3300 MIDLAND AVE
MEMPHIS TN
38111-4318
US

V. Phone/Fax

Practice location:
  • Phone: 870-932-1198
  • Fax:
Mailing address:
  • Phone: 573-424-5952
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number28428
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number4189
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number4189
License Number StateTN
# 4
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberE-13764
License Number StateAR
# 5
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number28428
License Number StateMS
# 6
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number2017013013
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: