Healthcare Provider Details

I. General information

NPI: 1407060700
Provider Name (Legal Business Name): ROBIN C WILLIAMS, MD, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 02/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 VIRGINIA DR
BATESVILLE AR
72501-7329
US

IV. Provider business mailing address

411 VIRGINIA DR
BATESVILLE AR
72501-7329
US

V. Phone/Fax

Practice location:
  • Phone: 870-698-9747
  • Fax:
Mailing address:
  • Phone: 870-698-9747
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberR4485
License Number StateAR

VIII. Authorized Official

Name: DR. ROBIN C WILLIAMS
Title or Position: OWNER
Credential: M.D.
Phone: 870-698-9747