Provider Demographics
NPI:1942231865
Name:WILLIAMS, GEORGE RAYMOND (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:RAYMOND
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1233 WAYNE GILMORE CIRCLE
Mailing Address - Street 2:SUITE 250-A
Mailing Address - City:OPELOUSAS
Mailing Address - State:LA
Mailing Address - Zip Code:70570
Mailing Address - Country:US
Mailing Address - Phone:337-948-8556
Mailing Address - Fax:337-948-6881
Practice Address - Street 1:1233 WAYNE GILMORE CIRCLE
Practice Address - Street 2:SUITE 250-A
Practice Address - City:OPELOUSAS
Practice Address - State:LA
Practice Address - Zip Code:70570
Practice Address - Country:US
Practice Address - Phone:337-948-8556
Practice Address - Fax:337-948-6881
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA021658207XX0801X, 207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
No207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1672271Medicaid
LA5W562Medicare PIN
LA1672271Medicaid
LAG22271Medicare UPIN