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General NPI Number Information
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NPI Number | 1467608026
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Entity Type | Organization
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Legal Business Name | DEBRA J WILLIAMS PODIATRIST PC
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Dates
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Enumeration Date | 08/14/2008
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Last Update Date | 08/14/2008
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Provider Practice Location Address
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Address Line | 720 STATE ST
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City | CARTHAGE
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State | NY
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Zip | 13619-1404
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Country | US
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Telephone | 315-493-6949
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Fax | 315-493-2445
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Provider Business Mailing Address
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Address Line | 720 STATE ST
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City | CARTHAGE
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State | NY
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Zip | 13619-1404
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Country | US
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Telephone | 315-493-6949
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Fax | 315-493-2445
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Authorized Official
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Title or Position | PODIATRIST PC
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Name | MISS DEBRA J WILLIAMS
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Credential | DPM
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Telephone | 315-493-6949
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP1100X
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Taxonomy Name | Podiatric Clinic/Center
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License Number | N0044661
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License Number State | NY
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