Doctor Name: | OPAL WILLIAMS |
NPI Number: | 1720395056 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP |
License Number: | RN142311 |
Business Practice Address: | 245 Peachtree Industrial Blvd Sugar Hill, GA - 30518 |
Business Phone Number: | 6785410777 |
Business Fax Number: | 6785410780 |
Mailing Address: | 245 Peachtree Industrial Blvd, SUGAR HILL |
State: | GA |
Postal Code: | 30518 |
Phone Number: | 6785410777 |
Fax Number: | 6785410780 |
NPI Enumeration Date: | 09/08/2010 |
NPI Last Update Date: | 09/20/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | RN142311 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |