Provider Demographics
NPI:1386656593
Name:WILLIAMS-RAHMING, LORRAINE M (MD)
Entity Type:Individual
Prefix:
First Name:LORRAINE
Middle Name:M
Last Name:WILLIAMS-RAHMING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LORRAINE
Other - Middle Name:M
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15125 US HIGHWAY 19 S STE 364
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31792-4853
Mailing Address - Country:US
Mailing Address - Phone:850-900-1125
Mailing Address - Fax:850-900-1127
Practice Address - Street 1:706 S BROAD ST
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:GA
Practice Address - Zip Code:31792-6107
Practice Address - Country:US
Practice Address - Phone:229-228-2400
Practice Address - Fax:229-584-5940
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA069670174400000X, 207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003132942AMedicaid
CAH80524Medicare UPIN