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General NPI Number Information
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NPI Number | 1548417272
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Entity Type | Organization
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Legal Business Name | CHARLES T WILLIAMS MD PC
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Dates
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Enumeration Date | 08/25/2008
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Last Update Date | 08/25/2008
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Provider Practice Location Address
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Address Line | 9150 W INDIAN SCHOOL RD UNIT 8, SUITE 131
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City | PHOENIX
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State | AZ
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Zip | 85037-2384
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Country | US
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Telephone | 623-848-8833
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Fax | 623-848-8227
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Provider Business Mailing Address
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Address Line | PO BOX 14428
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City | PHOENIX
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State | AZ
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Zip | 85063-4428
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Country | US
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Telephone | 623-848-8833
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Fax | 623-848-8227
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | CHARLES T WILLIAMS
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Credential | M.D.
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Telephone | 623-848-8833
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 12804
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License Number State | AZ
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