Provider Demographics
NPI:1588432066
Name:WILLIAMS, ANNE MARIE
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:MARIE
Last Name:WILLIAMS
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 1:4658 PRESIDENTIAL PKWY # 1289
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31206-8708
Mailing Address - Country:US
Mailing Address - Phone:478-227-3329
Mailing Address - Fax:
Practice Address - Street 1:3444 DOSTER WAY
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31217-4908
Practice Address - Country:US
Practice Address - Phone:478-227-3329
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-14
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier