Doctor Name: | CYNDI ANDREA WILLIAMS-GREEN |
NPI Number: | 1205994985 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PHYSICIANASSISTANT |
License Number: | 3051 |
Business Practice Address: | 201 Avera Dr Fort Valley, GA - 310305008 |
Business Phone Number: | 4788253317 |
Business Fax Number: | 4788255499 |
Mailing Address: | 229 Ellicott Dr, WARNER ROBINS |
State: | GA |
Postal Code: | 310883057 |
Phone Number: | 4789717468 |
Fax Number: | 4788255499 |
NPI Enumeration Date: | 12/05/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 3051 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |