Provider Demographics
NPI:1982971784
Name:WILLIAMS, DONNELL LAMAR (PHARMD, CGP, BC-ADM)
Entity type:Individual
Prefix:DR
First Name:DONNELL
Middle Name:LAMAR
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:PHARMD, CGP, BC-ADM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4803
Mailing Address - Street 2:
Mailing Address - City:EASTMAN
Mailing Address - State:GA
Mailing Address - Zip Code:31023-4803
Mailing Address - Country:US
Mailing Address - Phone:478-272-1210
Mailing Address - Fax:
Practice Address - Street 1:1826 VETERANS BLVD
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:GA
Practice Address - Zip Code:31021-3620
Practice Address - Country:US
Practice Address - Phone:478-272-1210
Practice Address - Fax:478-274-5508
Is Sole Proprietor?:No
Enumeration Date:2011-11-22
Last Update Date:2015-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH-0263751835P1200X
FLPS-484181835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPS-48418OtherSTATE PHARMACIST LICENSE
GARPH-026375OtherSTATE PHARMACIST LICENSE