Healthcare Provider Details

I. General information

NPI: 1083680862
Provider Name (Legal Business Name): ROBIN C WILLIAMS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2006
Last Update Date: 11/07/2011
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: 870-698-0301
Mailing address:
  • Phone: 870-698-9747
  • Fax: 870-698-0301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberR4485
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberR4485
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: