Provider Demographics
NPI:1487064051
Name:PHYSICIAN DISABILITY EXAMINATION SERVICES INC
Entity type:Organization
Organization Name:PHYSICIAN DISABILITY EXAMINATION SERVICES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RASHEEDA
Authorized Official - Middle Name:G
Authorized Official - Last Name:WILLIAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-573-0039
Mailing Address - Street 1:6600 SUGARLOAF PKWY
Mailing Address - Street 2:SUITE 400 #290
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30097
Mailing Address - Country:US
Mailing Address - Phone:229-573-0039
Mailing Address - Fax:888-684-8452
Practice Address - Street 1:108 BYRD WAY STE 100
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-9195
Practice Address - Country:US
Practice Address - Phone:954-791-1600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-05
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS10135208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty