Williams, Samuel Gregory

Williams, Samuel Gregory is an individual health care provider with primary practice located at 1040 Division St , Mauston WI 53948-1931. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Williams, Samuel Gregory can be contacted via phone (608) 847-5000.

Contact Information

Primary practice address
1040 Division St Mauston WI 53948-1931
Phone: (608) 847-5000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 363 Wisconsin

Profile Details

NPI number 1871580332
LBN Legal business name Williams, Samuel Gregory
Credentials PAC
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 30th, 2005
Last updated Jul 16th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871580332 NPPES
Wisconsin MEDICAID 42939400

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