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General NPI Number Information
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NPI Number | 1942580493
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Entity Type | Individual
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Provider Name | GAYNELL WILLIAMS GEORGE RPH
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Gender | Female
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Dates
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Enumeration Date | 08/27/2011
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Last Update Date | 08/27/2011
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Provider Practice Location Address
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Address Line | 9465 HIGHWAY 5
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City | DOUGLASVILLE
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State | GA
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Zip | 30135-1509
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Country | US
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Telephone | 678-715-8494
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Fax | 678-715-8504
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Provider Business Mailing Address
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Address Line | 5147 LAKECOVE CT
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City | DOUGLASVILLE
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State | GA
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Zip | 30135-7656
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Country | US
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Telephone | 504-621-9774
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Fax | 678-391-2851
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH022934
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 13480
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License Number State | LA
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