Larry Williams, M.D.
Individual provider Active NPI General Practice Physician · Whitesburg, GA
NPI 1669856100 · NPPES record last updated Jul 15, 2015
Key facts
- NPI
- 1669856100
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Physician 208D00000X
- License
- 011094 (GA)
- Practice address
- 575 Teepee TRL
Whitesburg, GA 30185-2267 - Phone
- (770) 214-2515
- NPI assigned
- Jul 15, 2015
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 011094 | GA | MD | General Practice Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 011094 | GA | Yes |
Addresses
Primary practice location
575 Teepee TRL
Whitesburg, GA 30185-2267
Mailing address
575 Teepee TRL
Whitesburg, GA 30185-2267
Phone (770) 214-2515
Other providers in Whitesburg, GA
All providers in Whitesburg, GA · General Practice Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 15, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.