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NPI Code Detail

MEDICARE: AMANDA L WILLIAMS PA

MEDICARE: AMANDA L WILLIAMS PA
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
1363AM0700XMedical Physician AssistantA10583LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1538159488
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA L WILLIAMS PA
Provider Business Mailing Address
First Line : 7777 HENNESSY BLVD
Second Line : SUITE 103
City : BATON ROUGE
State : LA
Zip : 70808
Country : US
Telephone Number : 225-767-6700
Fax Number :
Provider Business Practice Location Address
First Line : 16777 MEDICAL CENTER DR
Second Line :
City : BATON ROUGE
State : LA
Zip : 70816-3254
Country : US
Telephone Number : 225-754-5191
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2005
Last Update Date : 12/29/2016

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Directions to “ AMANDA L WILLIAMS PA” Practice Location

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