Provider Demographics
NPI:1548345127
Name:MCWILLIAMS, PHILIP ANTHONY (DC)
Entity type:Individual
Prefix:
First Name:PHILIP
Middle Name:ANTHONY
Last Name:MCWILLIAMS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4153 LAWRENCEVILLE HWY NW
Mailing Address - Street 2:SUITE 3
Mailing Address - City:LILBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30047-2854
Mailing Address - Country:US
Mailing Address - Phone:770-381-6522
Mailing Address - Fax:770-381-6542
Practice Address - Street 1:4153 LAWRENCEVILLE HWY NW
Practice Address - Street 2:SUITE 3
Practice Address - City:LILBURN
Practice Address - State:GA
Practice Address - Zip Code:30047-2854
Practice Address - Country:US
Practice Address - Phone:770-381-6522
Practice Address - Fax:770-381-6542
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2746111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA35ZCGQSMedicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
GAU70299Medicare UPIN