Healthcare Provider Details

I. General information

NPI: 1033393988
Provider Name (Legal Business Name): DOLORES GORDON-WILLIAMS M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DOLORES GORDON

II. Dates (important events)

Enumeration Date: 12/27/2007
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3111 S 70TH ST
FORT SMITH AR
72903-5017
US

IV. Provider business mailing address

PO BOX 11818
FORT SMITH AR
72917-1818
US

V. Phone/Fax

Practice location:
  • Phone: 479-452-6650
  • Fax: 479-452-5847
Mailing address:
  • Phone: 479-452-6650
  • Fax: 479-452-5847

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number8275C
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: