Provider Demographics
NPI:1396791059
Name:WILLIAMS, JIMMIE EUGENE (MD)
Entity type:Individual
Prefix:DR
First Name:JIMMIE
Middle Name:EUGENE
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:285 BOULEVARD NE
Mailing Address - Street 2:SUITE 220
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30312-4205
Mailing Address - Country:US
Mailing Address - Phone:404-688-6400
Mailing Address - Fax:404-688-0716
Practice Address - Street 1:550 PEACHTREE STREET
Practice Address - Street 2:SUITE 1220
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308
Practice Address - Country:US
Practice Address - Phone:404-688-6400
Practice Address - Fax:404-688-0716
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-25
Last Update Date:2012-05-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA17008207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00116575AMedicaid
041395Medicare UPIN