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NPI Code Detail

MEDICARE: DR. WILLIE GOLDEN WILLIAMS DDS

MEDICARE: DR. WILLIE GOLDEN WILLIAMS DDS
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
1122300000XDentist5609LA

Other Identifiers

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

General Provider Information

NPI Number : 1700915550
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WILLIE GOLDEN WILLIAMS DDS
Provider Business Mailing Address
First Line : PO BOX 1815
Second Line :
City : OPELOUSAS
State : LA
Zip : 70571-1815
Country : US
Telephone Number : 337-942-3390
Fax Number : 337-942-8644
Provider Business Practice Location Address
First Line : 8762 HIGHWAY 182
Second Line :
City : OPELOUSAS
State : LA
Zip : 70570-5603
Country : US
Telephone Number : 337-942-2005
Fax Number : 337-942-8644
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/05/2007
Last Update Date : 07/09/2007

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