MEDICARE: DAVID BARTOW WILLIAMS CAA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367H00000X	Anesthesiologist Assistant		IN
2	367H00000X	Anesthesiologist Assistant	75000009A	IN

General Provider Information

NPI Number	:	1124563556
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID BARTOW WILLIAMS CAA

Provider Business Mailing Address
First Line	:	720 ESKENAZI AVE
Second Line	:	FIFTH THIRD BANK BLDG, 5TH FL
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46202-5166
Country	:	US
Telephone Number	:	317-880-4121
Fax Number	:	317-880-0343

Provider Business Practice Location Address
First Line	:	455 SAINT MICHAELS DR
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87505-7601
Country	:	US
Telephone Number	:	505-795-4227
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/20/2016
Last Update Date	:	06/01/2026

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Directions to “ DAVID BARTOW WILLIAMS CAA” Practice Location

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