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NPI Code Detail

MEDICARE: MATTHEW DIMMICK WILLIAMS M.D.

MEDICARE: MATTHEW DIMMICK WILLIAMS M.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
1207X00000XOrthopaedic Surgery PhysicianM3793TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MD.25597OTHERLAMEDICAL LICENSE

General Provider Information

NPI Number : 1942219894
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTHEW DIMMICK WILLIAMS M.D.
Provider Business Mailing Address
First Line : 108 RUE LOUIS XIV
Second Line :
City : LAFAYETTE
State : LA
Zip : 70508-5739
Country : US
Telephone Number : 337-235-8007
Fax Number : 855-270-5479
Provider Business Practice Location Address
First Line : 108 RUE LOUIS XIV
Second Line :
City : LAFAYETTE
State : LA
Zip : 70508-5739
Country : US
Telephone Number : 337-235-8007
Fax Number : 855-270-5479
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/07/2006
Last Update Date : 11/29/2016

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