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NPI Code Detail

MEDICARE: NORRIS WILLIAMS SR. PA-C

MEDICARE: NORRIS WILLIAMS SR. PA-C
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
1363A00000XPhysician Assistant001844GA

General Provider Information

NPI Number : 1699871822
Entity Type Code : Individual
Provider Name (Legal Business Name) : NORRIS WILLIAMS SR. PA-C
Provider Business Mailing Address
First Line : 4519 WOODRUFF RD
Second Line : SUITE 4 PMB 349
City : COLUMBUS
State : GA
Zip : 31904-6011
Country : US
Telephone Number : 706-653-2329
Fax Number : 706-653-2329
Provider Business Practice Location Address
First Line : 2737 WARM SPRINGS RD
Second Line : SUITE B & C
City : COLUMBUS
State : GA
Zip : 31904-6859
Country : US
Telephone Number : 706-576-5149
Fax Number : 706-576-5150
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/15/2006
Last Update Date : 04/06/2010

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