Healthcare Provider Details

I. General information

NPI: 1861441214
Provider Name (Legal Business Name): IFOR R. WILLIAMS M.D., PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 MICHAEL ST NE WHITEHEAD BIOMEDICAL RESEARCH BLDG., RM. 105-D
ATLANTA GA
30322-1047
US

IV. Provider business mailing address

615 MICHAEL ST NE WHITEHEAD BIOMEDICAL RESEARCH BLDG., RM. 105-D
ATLANTA GA
30322-1047
US

V. Phone/Fax

Practice location:
  • Phone: 404-727-8547
  • Fax: 404-727-8538
Mailing address:
  • Phone: 404-727-8547
  • Fax: 404-727-8538

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License Number044605
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code207ZI0100X
TaxonomyImmunopathology Physician
License Number044605
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: