Healthcare Provider Details

I. General information

NPI: 1275708224
Provider Name (Legal Business Name): ALTON ALLEN WILLIAMS O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2008
Last Update Date: 04/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 CHRISTIANA MEDICAL CTR
NEWARK DE
19702-1697
US

IV. Provider business mailing address

100 CHRISTIANA MEDICAL CTR
NEWARK DE
19702-1697
US

V. Phone/Fax

Practice location:
  • Phone: 302-283-1988
  • Fax: 302-283-1991
Mailing address:
  • Phone: 302-283-1988
  • Fax: 302-283-1991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number1132
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: