MEDICARE: MR. ANTOINE GREGOIRE WILLIAMS SR.

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	343900000X	Non-emergency Medical Transport (VAN)	006835956	LA

General Provider Information

NPI Number	:	1801606678
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ANTOINE GREGOIRE WILLIAMS SR.

Provider Business Mailing Address
First Line	:	168 MARY JANE LN
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70128-1575
Country	:	US
Telephone Number	:	501-319-2896
Fax Number	:

Provider Business Practice Location Address
First Line	:	168 MARY JANE LN
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70128-1575
Country	:	US
Telephone Number	:	501-319-2896
Fax Number	:

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

Provider Enumeration Date	:	01/13/2025
Last Update Date	:	01/13/2025

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