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General NPI Number Information
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NPI Number | 1235193228
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Entity Type | Individual
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Provider Name | GEORGE WELDON WILLIAMS DO
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Gender | Male
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Dates
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Enumeration Date | 04/14/2006
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Last Update Date | 03/22/2017
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Provider Practice Location Address
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Address Line | 1110 W FLORIDA ST
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City | DEMING
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State | NM
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Zip | 88030-4908
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Country | US
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Telephone | 505-546-4811
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Fax | 505-546-4821
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Provider Business Mailing Address
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Address Line | 122 S GOLD AVE STE 3
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City | DEMING
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State | NM
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Zip | 88030-3755
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Country | US
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Telephone | 575-545-7280
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Fax | 575-544-7281
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A92590
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License Number State | NM
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