MEDICARE: CALVIN WILLIAMS

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	2086S0129X	Vascular Surgery Physician	OS20767	FL

General Provider Information

NPI Number	:	1801335898
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CALVIN WILLIAMS

Provider Business Mailing Address
First Line	:	PO BOX 935921
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	31193-5921
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	501 LIVE OAK ST STE B
Second Line	:
City	:	NEW SMYRNA BEACH
State	:	FL
Zip	:	32168-7300
Country	:	US
Telephone Number	:	386-231-3600
Fax Number	:	386-231-3600

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

Provider Enumeration Date	:	02/23/2017
Last Update Date	:	09/09/2024

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Directions to “ CALVIN WILLIAMS ” Practice Location

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