Provider Demographics
NPI:1487875522
Name:WILLIAMS, WILLIAM EDWARD (DO)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:EDWARD
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:107 BUFFALO
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72830-6104
Mailing Address - Country:US
Mailing Address - Phone:479-754-4721
Mailing Address - Fax:844-584-4213
Practice Address - Street 1:23 PROFESSIONAL PARK DR
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:AR
Practice Address - Zip Code:72830-4432
Practice Address - Country:US
Practice Address - Phone:479-754-4721
Practice Address - Fax:844-584-4213
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2015-10-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ARE5536207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR174874003Medicaid
AR5H215Medicare PIN