1386887362 NPI number — RACHAEL YUSON WILLIAMS M.D.

Table of content: RACHAEL YUSON WILLIAMS M.D. (NPI 1386887362)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386887362 NPI number — RACHAEL YUSON WILLIAMS M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WILLIAMS
Provider First Name:
RACHAEL
Provider Middle Name:
YUSON
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1386887362
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/15/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
EMORY UNIVERSITY SCHOOL OF MEDICINE
Provider Second Line Business Mailing Address:
1762 CLIFTON RAOD, SUITE J252
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30322-0001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
404-727-9610
Provider Business Mailing Address Fax Number:
404-712-1540

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7325 MEDICAL CENTER DR STE 200
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WEST HILLS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91307-1938
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-981-2050
Provider Business Practice Location Address Fax Number:
818-981-2382
Provider Enumeration Date:
04/07/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208600000X , with the licence number:  159969 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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