Provider Demographics
NPI:1336140052
Name:WILLIAMS, LAWRENCE H (MD)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:H
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 ENTERPRISE COURT
Mailing Address - Street 2:SUITE C
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904
Mailing Address - Country:US
Mailing Address - Phone:706-321-0476
Mailing Address - Fax:706-321-2508
Practice Address - Street 1:3934 WOODRUFF RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-6818
Practice Address - Country:US
Practice Address - Phone:706-322-0304
Practice Address - Fax:706-327-0870
Is Sole Proprietor?:No
Enumeration Date:2005-08-03
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA024375207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA11BDJHTMedicare ID - Type UnspecifiedMD