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General NPI Number Information
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NPI Number | 1417054891
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Entity Type | Organization
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Legal Business Name | ROSS H WILLIAMS OD, PC
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 01/21/2008
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Provider Practice Location Address
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Address Line | 4067 E COURT ST SIUTE 10
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City | BURTON
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State | MI
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Zip | 48509-2509
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Country | US
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Telephone | 810-230-1600
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Fax | 810-715-2027
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Provider Business Mailing Address
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Address Line | 4067 E COURT ST SIUTE 10
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City | BURTON
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State | MI
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Zip | 48509-2509
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Country | US
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Telephone | 810-230-1600
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Fax | 810-715-2027
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. THERESA K WILLIAMS
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Credential |
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Telephone | 810-230-1600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 4901002528
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License Number State | MI
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