MEDICARE: MR. JERROD LAQUINTON WILLIAMS SR. CSA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AS0400X	Surgical Physician Assistant	2610	GA

General Provider Information

NPI Number	:	1457481368
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JERROD LAQUINTON WILLIAMS SR. CSA

Provider Business Mailing Address
First Line	:	PO BOX 420429
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30342-0429
Country	:	US
Telephone Number	:	404-932-0295
Fax Number	:

Provider Business Practice Location Address
First Line	:	207 ARABELLA PKWY
Second Line	:
City	:	LOCUST GROVE
State	:	GA
Zip	:	30248-4250
Country	:	US
Telephone Number	:	404-932-0295
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/07/2007
Last Update Date	:	05/03/2026

Similar Medicare Providers

1225218704 — MS. JEANNE ALBERTA DICKERSON LCPC
Practice Location Address:

5450 ASHBROOK PL
DOWNERS GROVE, IL
60515-4250

Practice Phone: 630-986-8310
Practice Fax:

1184938292 — MR. BRYAN MICHAEL BUMGARDNER LPN
Practice Location Address:

4250 CHICKEN COOP RD
SUGAR GROVE, OH
43155-9725

Practice Phone: 740-746-8415
Practice Fax:

1548107170 — EMPOWERED PATHWAYS HOUSING INITIATIVE CORP
Practice Location Address:

1344 DEUTZ DR
LOCUST GROVE, GA
30248-1107

Practice Phone: 404-901-8273
Practice Fax:

1518808153 — ANYI NURTURES LLC
Practice Location Address:

637 KIMBERWICK DR
LOCUST GROVE, GA
30248-4643

Practice Phone: 678-663-2714
Practice Fax: 678-663-2714

1508601675 — MR. PATRICK LEE PEARSON JR. CSFA
Practice Location Address:

316 MADDI GRACE CT
LOCUST GROVE, GA
30248-9801

Practice Phone: 678-464-6326
Practice Fax: 678-823-6937

1033051545 — PEARSON SURGICAL PRO LLC
Practice Location Address:

316 MADDI GRACE CT
LOCUST GROVE, GA
30248-9801

Practice Phone: 678-464-6326
Practice Fax: 678-823-6937

Directions to “ MR. JERROD LAQUINTON WILLIAMS SR. CSA” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.