Provider Demographics
NPI:1174523260
Name:WILLIAMS, DAVID L (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:L
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3426 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-6277
Mailing Address - Country:US
Mailing Address - Phone:501-318-9895
Mailing Address - Fax:501-318-9906
Practice Address - Street 1:3426 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-6277
Practice Address - Country:US
Practice Address - Phone:501-318-9895
Practice Address - Fax:501-318-9906
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2016-06-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXG0286207Q00000X
ARR3533207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR107798001Medicaid
TX138135212Medicaid
TX138135212Medicaid
AR107798001Medicaid