Provider Demographics
NPI:1386752673
Name:WILLIAMS, JASON CHRISTOPHER (MD)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:CHRISTOPHER
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 1:406 W 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31701-2202
Mailing Address - Country:US
Mailing Address - Phone:229-439-9400
Mailing Address - Fax:229-436-3718
Practice Address - Street 1:406 W 1ST AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31701-2202
Practice Address - Country:US
Practice Address - Phone:229-439-9400
Practice Address - Fax:229-436-3718
Is Sole Proprietor?:No
Enumeration Date:2006-08-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA047869207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA100671OtherBLUE CROSS BLUE SHIELD
GAH59033Medicare UPIN
GA05BDJDVMedicare ID - Type UnspecifiedGRP 1582