Basic Information
| Provider Information | |||||||||
| NPI: | 1669475943 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KEATON WILLIAMS | ||||||||
| FirstName: | ROTONDA | ||||||||
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| NamePrefix: | MRS. | ||||||||
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| Credential: | P.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1100 JOHNSON FERRY RD NE | ||||||||
| Address2: | SUITE510 | ||||||||
| City: | SANDY SPRINGS | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303421709 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4044191165 | ||||||||
| FaxNumber: | 4044191164 | ||||||||
| Practice Location | |||||||||
| Address1: | 1498 KLONDIKE RD SW | ||||||||
| Address2: | SUITE 106 | ||||||||
| City: | CONYERS | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300945169 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7707617260 | ||||||||
| FaxNumber: | 6784131818 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/31/2005 | ||||||||
| LastUpdateDate: | 09/30/2011 | ||||||||
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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 | 363A00000X | 004174 | GA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.