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NPI Code Detail

MEDICARE: DR. CECILIA PURSEL WILLIAMS O.D.

MEDICARE: DR. CECILIA PURSEL WILLIAMS O.D.
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
1152W00000XOptometrist0618000529VA

General Provider Information

NPI Number : 1649274457
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CECILIA PURSEL WILLIAMS O.D.
Provider Business Mailing Address
First Line : 7241 COMMERCE ST
Second Line :
City : SPRINGFIELD
State : VA
Zip : 22150-3411
Country : US
Telephone Number : 703-866-9364
Fax Number : 703-866-9198
Provider Business Practice Location Address
First Line : 7241 COMMERCE ST
Second Line :
City : SPRINGFIELD
State : VA
Zip : 22150-3411
Country : US
Telephone Number : 703-866-9364
Fax Number : 703-866-9198
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2005
Last Update Date : 07/08/2007

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