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General NPI Number Information
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NPI Number | 1609207034
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Entity Type | Organization
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Legal Business Name | ONESOURCE HEALTHCARE GROUP, LLC
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Dates
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Enumeration Date | 12/11/2013
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Last Update Date | 08/27/2014
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Provider Practice Location Address
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Address Line | 701 N SLAPPEY BLVD
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City | ALBANY
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State | GA
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Zip | 31701-1413
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Country | US
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Telephone | 229-300-5896
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Fax | 229-482-8586
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Provider Business Mailing Address
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Address Line | 701 N SLAPPEY BLVD
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City | ALBANY
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State | GA
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Zip | 31701-1413
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Country | US
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Telephone | 229-300-5896
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Fax | 229-482-8586
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Authorized Official
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Title or Position | CMO
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Name | JONATHAN S WILLIAMS
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Credential | D.O.
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Telephone | 229-300-5896
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 059237
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | GA
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