Healthcare Provider Details

I. General information

NPI: 1548465016
Provider Name (Legal Business Name): ROBERT J WILLIAMS, MD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 S WASHINGTON ST
LINCOLNTON GA
30817-2870
US

IV. Provider business mailing address

PO BOX 189
LINCOLNTON GA
30817-0189
US

V. Phone/Fax

Practice location:
  • Phone: 706-359-4215
  • Fax: 706-359-1662
Mailing address:
  • Phone: 706-359-4215
  • Fax: 706-359-1662

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number29263
License Number StateGA

VIII. Authorized Official

Name: ROBERT JACKSON WILLIAMS
Title or Position: MD
Credential:
Phone: 706-359-4215