Healthcare Provider Details

I. General information

NPI: 1235359720
Provider Name (Legal Business Name): WILLIAMS, MOATES & MOATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 PARK ST STE A
LEESBURG GA
31763
US

IV. Provider business mailing address

1119 E LAMAR ST P O BOX 788
AMERICUS GA
31709-3762
US

V. Phone/Fax

Practice location:
  • Phone: 229-759-0028
  • Fax: 229-759-0058
Mailing address:
  • Phone: 229-924-4022
  • Fax: 229-924-7133

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RAY D WILLIAMS
Title or Position: PARTNER
Credential: O.D.
Phone: 229-924-4022