Provider Demographics
NPI:1255568457
Name:WILLIAMS, SHAUN R (MD)
Entity type:Individual
Prefix:
First Name:SHAUN
Middle Name:R
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:P.O. BOX 2445, CLIENT 503
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31902-2445
Mailing Address - Country:US
Mailing Address - Phone:706-323-0111
Mailing Address - Fax:334-395-4110
Practice Address - Street 1:2122 MANCHESTER EXPRESSWAY
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-6878
Practice Address - Country:US
Practice Address - Phone:334-279-1450
Practice Address - Fax:334-395-4110
Is Sole Proprietor?:No
Enumeration Date:2009-06-15
Last Update Date:2016-01-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA071587207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology