Provider Demographics
NPI:1346252426
Name:WILLIAMS, GREGG JOSEPH (DPM, MBA)
Entity Type:Individual
Prefix:DR
First Name:GREGG
Middle Name:JOSEPH
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:DPM, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7311 DOWNMAN RD
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70126-1213
Mailing Address - Country:US
Mailing Address - Phone:504-241-5707
Mailing Address - Fax:594-241-1945
Practice Address - Street 1:7311 DOWNMAN RD
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70126-1213
Practice Address - Country:US
Practice Address - Phone:504-241-5707
Practice Address - Fax:504-241-1945
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPD256R213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1432971Medicaid
LA1432971Medicaid
LA5H289Medicare ID - Type Unspecified