Healthcare Provider Details

I. General information

NPI: 1689670390
Provider Name (Legal Business Name): WILLIAMS EYE INSTITUTE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2005
Last Update Date: 10/09/2024
Certification Date: 10/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6836 HOHMAN AVENUE
HAMMOND IN
46324-1410
US

IV. Provider business mailing address

9797 MASSACHUSETTS ST
CROWN POINT IN
46307-0278
US

V. Phone/Fax

Practice location:
  • Phone: 219-937-5063
  • Fax: 219-937-5093
Mailing address:
  • Phone: 219-736-2200
  • Fax: 219-937-5093

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number010110
License Number StateIN

VIII. Authorized Official

Name: DR. DOUGLAS PAUL WILLIAMS
Title or Position: PRESIDENT
Credential:
Phone: 219-736-2200