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NPI Code Detail

MEDICARE: UTON WILLIAMS CSA

MEDICARE: UTON WILLIAMS 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
1246ZC0007XSurgical Assistant4858GA

General Provider Information

NPI Number : 1518467224
Entity Type Code : Individual
Provider Name (Legal Business Name) : UTON WILLIAMS CSA
Provider Business Mailing Address
First Line : 5401 SAND BAR LN
Second Line :
City : ATLANTA
State : GA
Zip : 30349-3063
Country : US
Telephone Number : 404-732-6404
Fax Number : 404-855-4243
Provider Business Practice Location Address
First Line : 5401 SAND BAR LN
Second Line :
City : COLLEGE PARK
State : GA
Zip : 30349-3063
Country : US
Telephone Number : 214-227-2457
Fax Number : 214-764-0880
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/19/2018
Last Update Date : 10/26/2020

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