Healthcare Provider Details

I. General information

NPI: 1952969859
Provider Name (Legal Business Name): LAREZIA DENISE WILLIAMS OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2019
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 W ELM ST
ATHENS AL
35611-4802
US

IV. Provider business mailing address

433 HIGHLAND TRAIL AVE
GARDENDALE AL
35071-4014
US

V. Phone/Fax

Practice location:
  • Phone: 256-262-0200
  • Fax: 256-262-0201
Mailing address:
  • Phone: 334-669-0515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPC6059
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberS-E24-TA-B56
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: