Healthcare Provider Details

I. General information

NPI: 1942231865
Provider Name (Legal Business Name): GEORGE RAYMOND WILLIAMS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 01/07/2021
Certification Date: 01/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1233 WAYNE GILMORE CIRCLE SUITE 250-A
OPELOUSAS LA
70570
US

IV. Provider business mailing address

1233 WAYNE GILMORE CIRCLE SUITE 250-A
OPELOUSAS LA
70570
US

V. Phone/Fax

Practice location:
  • Phone: 337-948-8556
  • Fax: 337-948-6881
Mailing address:
  • Phone: 337-948-8556
  • Fax: 337-948-6881

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XX0801X
TaxonomyOrthopaedic Trauma Physician
License Number021658
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number021658
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: