Healthcare Provider Details

I. General information

NPI: 1467422048
Provider Name (Legal Business Name): THOMAS ST CLAIR WILLIAMS SR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/25/2006
Last Update Date: 12/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

516 LINCOLN RD
MONROE LA
71203-4252
US

IV. Provider business mailing address

PO BOX 13430
MONROE LA
71213-3430
US

V. Phone/Fax

Practice location:
  • Phone: 318-343-6487
  • Fax: 318-343-7884
Mailing address:
  • Phone: 318-343-6487
  • Fax: 318-343-7884

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD022964
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number022964
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: