Provider Demographics
NPI:1982349031
Name:WILLIAMS-WARE, TIPHANY
Entity Type:Individual
Prefix:
First Name:TIPHANY
Middle Name:
Last Name:WILLIAMS-WARE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 MARKET PLACE CONNECTOR # 1141
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269-3542
Mailing Address - Country:US
Mailing Address - Phone:404-907-7719
Mailing Address - Fax:404-601-9329
Practice Address - Street 1:212 SILVER RIDGE DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:GA
Practice Address - Zip Code:30157-8271
Practice Address - Country:US
Practice Address - Phone:404-907-7719
Practice Address - Fax:404-601-9329
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-03
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)