Basic Information
| Provider Information | |||||||||
| NPI: | 1578519161 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WILLIAMS | ||||||||
| FirstName: | ALANA | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1325 RALPH ABERNATHY BLVD SW | ||||||||
| Address2: | JENCARE NEIGHBORHOOD MEDICAL CENTER WEST END, LLC | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303101649 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4048360136 | ||||||||
| FaxNumber: | 4047535269 | ||||||||
| Practice Location | |||||||||
| Address1: | 1325 RALPH DAVID ABERNATHY BLVD. SW | ||||||||
| Address2: | JENCARE NEIGHBORHOOD MEDICAL CENTER WEST END, LLC | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303101649 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4048360136 | ||||||||
| FaxNumber: | 4047535269 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/25/2006 | ||||||||
| LastUpdateDate: | 01/06/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | 20082 | SC | N | Other Service Providers | Specialist | 207Q00000X | 61376 | GA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | T20082 | 05 | SC | MEDICAID |