Healthcare Provider Details

I. General information

NPI: 1528778131
Provider Name (Legal Business Name): WILLIAMS EYE INSTITUTE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2022
Last Update Date: 10/09/2024
Certification Date: 10/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9797 MASSACHUSETTS ST
CROWN POINT IN
46307-0278
US

IV. Provider business mailing address

9797 MASSACHUSETTS ST
CROWN POINT IN
46307-0278
US

V. Phone/Fax

Practice location:
  • Phone: 219-736-2200
  • Fax: 219-736-2222
Mailing address:
  • Phone: 219-736-2200
  • Fax: 219-937-5094

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: DOUGLAS P WILLIAMS MD
Title or Position: PRESIDENT
Credential:
Phone: 219-736-2200