MEDICARE: DR. ASHLEY WILLIAMS, LLC

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	213E00000X	Podiatrist

General Provider Information

NPI Number	:	1922618016
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. ASHLEY WILLIAMS, LLC

Provider Business Mailing Address
First Line	:	3223 HATCHET BAY DR APT 7203
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29414-5219
Country	:	US
Telephone Number	:	850-723-7932
Fax Number	:

Provider Business Practice Location Address
First Line	:	3223 HATCHET BAY DR APT 7203
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29414-5219
Country	:	US
Telephone Number	:	850-723-7932
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ASHLEY WILLIAMS
Credential	:	DPM
Telephone Number	:	850-723-7932

Provider Enumeration Date	:	08/04/2020
Last Update Date	:	08/04/2020

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