Provider Demographics
NPI:1609877059
Name:WILLIAMS, BARBARA BOSTWICK (DO)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:BOSTWICK
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1958
Mailing Address - Street 2:
Mailing Address - City:STATESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30459-1958
Mailing Address - Country:US
Mailing Address - Phone:912-871-2000
Mailing Address - Fax:912-871-2500
Practice Address - Street 1:1523 FAIR RD
Practice Address - Street 2:
Practice Address - City:STATESBORO
Practice Address - State:GA
Practice Address - Zip Code:30458-6025
Practice Address - Country:US
Practice Address - Phone:912-871-2000
Practice Address - Fax:912-871-2500
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-09
Last Update Date:2011-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA049353207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA01394192OtherAMERIGROUP
GA428778302DMedicaid
GA428778302IMedicaid
H88757Medicare UPIN
GA01394192OtherAMERIGROUP