MEDICARE: DR. JOEL ALFRED WILLIAMS III MD

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	2086S0122X	Plastic and Reconstructive Surgery Physician	O46516	GA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	240006272	OTHER	GA	RAILROAD MEDICARE

General Provider Information

NPI Number	:	1821072406
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOEL ALFRED WILLIAMS III MD

Provider Business Mailing Address
First Line	:	1506 PROFESSIONAL CT
Second Line	:
City	:	DALTON
State	:	GA
Zip	:	30720-2500
Country	:	US
Telephone Number	:	706-278-2700
Fax Number	:	706-278-3444

Provider Business Practice Location Address
First Line	:	1506 PROFESSIONAL CT
Second Line	:
City	:	DALTON
State	:	GA
Zip	:	30720-2500
Country	:	US
Telephone Number	:	706-278-2700
Fax Number	:	706-278-3444

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

Provider Enumeration Date	:	12/06/2005
Last Update Date	:	07/31/2012

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