=====================================================
General NPI Number Information
=====================================================
NPI Number | 1447243043
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | QUINTESSA BRITTON-WILLIAMS M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/30/2005
-----------------------------------------------------
Last Update Date | 07/15/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 301 ANDREWS AVENUE, BUILDING 301
-----------------------------------------------------
City | FORT RUCKER
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 36362
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 334-255-7743
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1061 HARMON AVE SUITE 1DO3
-----------------------------------------------------
City | FORT STEWART
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 31314-5604
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 912-435-6979
-----------------------------------------------------
Fax | 912-435-6706
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | 054556
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------