Provider Demographics
NPI:1235359720
Name:WILLIAMS, MOATES & MOATES
Entity Type:Organization
Organization Name:WILLIAMS, MOATES & MOATES
Other - Org Name:REGIONAL EYE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAY
Authorized Official - Middle Name:D
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:229-924-4022
Mailing Address - Street 1:1119 E LAMAR ST
Mailing Address - Street 2:P O BOX 788
Mailing Address - City:AMERICUS
Mailing Address - State:GA
Mailing Address - Zip Code:31709-3762
Mailing Address - Country:US
Mailing Address - Phone:229-924-4022
Mailing Address - Fax:229-924-7133
Practice Address - Street 1:101 PARK ST
Practice Address - Street 2:STE A
Practice Address - City:LEESBURG
Practice Address - State:GA
Practice Address - Zip Code:31763
Practice Address - Country:US
Practice Address - Phone:229-759-0028
Practice Address - Fax:229-759-0058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Not Answered207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAG00012Medicare UPIN
GAU19586Medicare UPIN
GAU18172Medicare UPIN
GAV06962Medicare UPIN
GAU22356Medicare UPIN