Provider Demographics
NPI:1881961522
Name:WILLIAMS, JULIE MARGARET (MD)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:MARGARET
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 1:275 LONGSTREET DR
Mailing Address - Street 2:
Mailing Address - City:MODOC
Mailing Address - State:SC
Mailing Address - Zip Code:29838-2526
Mailing Address - Country:US
Mailing Address - Phone:864-333-5014
Mailing Address - Fax:
Practice Address - Street 1:4350 TOWNE CENTRE DR
Practice Address - Street 2:SUITE 2000
Practice Address - City:EVANS
Practice Address - State:GA
Practice Address - Zip Code:30809-3301
Practice Address - Country:US
Practice Address - Phone:706-832-5473
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-23
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA038403207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAF78533Medicare UPIN