Provider Demographics
NPI:1528845351
Name:WILLIAMS, GEORGE EARL JR
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:EARL
Last Name:WILLIAMS
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1719 LANG PL NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-3025
Mailing Address - Country:US
Mailing Address - Phone:919-592-1630
Mailing Address - Fax:
Practice Address - Street 1:1719 LANG PL NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-3025
Practice Address - Country:US
Practice Address - Phone:443-857-5469
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-14
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant