Healthcare Provider Details

I. General information

NPI: 1801502802
Provider Name (Legal Business Name): MS. MARGO WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/24/2023
Last Update Date: 01/30/2023
Certification Date: 01/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7030 N MAIN ST
DAYTON OH
45415-2557
US

IV. Provider business mailing address

4630 OWENS DR
DAYTON OH
45406-1341
US

V. Phone/Fax

Practice location:
  • Phone: 937-247-9102
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License NumberRN.144069
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: