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General NPI Number Information
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NPI Number | 1255734182
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Entity Type | Individual
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Provider Name | MR. HEATH TYRONE WILLIAMS
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Gender | Male
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Dates
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Enumeration Date | 10/06/2014
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Last Update Date | 10/06/2014
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Provider Practice Location Address
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Address Line | 3300 N CENTRAL AVE 2550
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City | PHOENIX
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State | AZ
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Zip | 85012-2501
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Country | US
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Telephone | 602-256-2525
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Fax |
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Provider Business Mailing Address
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Address Line | 750 E NORTHERN AVE 2009
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City | PHOENIX
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State | AZ
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Zip | 85020-4161
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Country | US
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Telephone | 480-593-5452
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number |
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License Number State |
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