Healthcare Provider Details

I. General information

NPI: 1164844023
Provider Name (Legal Business Name): LINDA WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/13/2014
Last Update Date: 01/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

590 SUN WOOD DR
SMITHS STATION AL
36877-4854
US

IV. Provider business mailing address

590 SUN WOOD DR
SMITHS STATION AL
36877-4854
US

V. Phone/Fax

Practice location:
  • Phone: 706-341-5990
  • Fax: 706-653-4172
Mailing address:
  • Phone: 706-341-5990
  • Fax: 706-653-4172

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: