Provider Demographics
NPI:1558634253
Name:JIMMIE E. WILLIAMS, M.D., P.C.
Entity type:Organization
Organization Name:JIMMIE E. WILLIAMS, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JIMMIE
Authorized Official - Middle Name:E
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-688-6400
Mailing Address - Street 1:285 BOULEVARD NE
Mailing Address - Street 2:SUITE 220
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30312-4205
Mailing Address - Country:US
Mailing Address - Phone:404-688-6400
Mailing Address - Fax:404-688-0716
Practice Address - Street 1:285 BOULEVARD NE
Practice Address - Street 2:SUITE 220
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30312-4205
Practice Address - Country:US
Practice Address - Phone:404-688-6400
Practice Address - Fax:404-688-0716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-12
Last Update Date:2012-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA17008261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center