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General NPI Number Information
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NPI Number | 1932402740
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Entity Type | Individual
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Provider Name | MELISSA LEWIS WILLIAMSON PA-C
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Gender | Female
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Dates
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Enumeration Date | 12/16/2010
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Last Update Date | 12/16/2010
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Provider Practice Location Address
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Address Line | 1303 DANTIGNAC ST STE 2100
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City | AUGUSTA
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State | GA
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Zip | 30901-2775
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Country | US
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Telephone | 706-396-0600
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Fax | 706-396-0660
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Provider Business Mailing Address
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Address Line | 4106 COLUMBIA RD STE 103
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City | MARTINEZ
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State | GA
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Zip | 30907-1450
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Country | US
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Telephone | 706-863-1440
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Fax | 706-863-5418
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 5931
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License Number State | GA
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