Provider Demographics
NPI:1154668093
Name:WILLIAMS, DAVID EARL (RPH)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:EARL
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7425 TRINDALE TRCE
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-8320
Mailing Address - Country:US
Mailing Address - Phone:404-405-0687
Mailing Address - Fax:770-772-4992
Practice Address - Street 1:11800 HAYNES BRIDGE RD
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30009-1898
Practice Address - Country:US
Practice Address - Phone:770-752-4966
Practice Address - Fax:770-772-4992
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-11
Last Update Date:2013-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH016587183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist