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General NPI Number Information
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NPI Number | 1073948444
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Entity Type | Individual
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Provider Name | GEORGE ALLEN WILLIAMS MD
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Gender | Male
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Dates
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Enumeration Date | 09/04/2013
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Last Update Date | 09/04/2013
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Provider Practice Location Address
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Address Line | 96 N LOS OLMOS
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City | GREEN VALLEY
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State | AZ
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Zip | 85614-2610
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Country | US
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Telephone | 520-777-6026
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Fax |
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Provider Business Mailing Address
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Address Line | 96 N LOS OLMOS
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City | GREEN VALLEY
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State | AZ
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Zip | 85614-2610
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Country | US
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Telephone | 520-777-6026
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 21497
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License Number State | AZ
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