Provider Demographics
NPI:1669536835
Name:WILLIAMS, DANIEL A (MD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:A
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 MILLERSPRINGS CT
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-5434
Mailing Address - Country:US
Mailing Address - Phone:770-836-0870
Mailing Address - Fax:770-836-1837
Practice Address - Street 1:1128 S PARK ST
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:GA
Practice Address - Zip Code:30119-4450
Practice Address - Country:US
Practice Address - Phone:770-836-0870
Practice Address - Fax:770-836-1837
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2014-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA37926207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA08BBRMPMedicare ID - Type UnspecifiedPROVIDER MEDICARE NUMBER
GAD17702Medicare UPIN