Provider Demographics
NPI:1881777019
Name:WILLIAMS, MARY JEAN (MD)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:JEAN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 W MONTGOMERY XRD
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-3309
Mailing Address - Country:US
Mailing Address - Phone:912-920-0214
Mailing Address - Fax:
Practice Address - Street 1:325 W. MONTGOMERY CROSS ROADS
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406
Practice Address - Country:US
Practice Address - Phone:912-920-0214
Practice Address - Fax:912-921-2004
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA047956207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine