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General NPI Number Information
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NPI Number | 1598462129
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Entity Type | Individual
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Provider Name | CASEY D WILLIAMS
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Gender | Male
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Dates
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Enumeration Date | 02/14/2023
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Last Update Date | 02/14/2023
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Provider Practice Location Address
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Address Line | 4951 S WHITE MOUNTAIN RD
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City | SHOW LOW
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State | AZ
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Zip | 85901-7827
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Country | US
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Telephone | 928-240-4128
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Fax |
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Provider Business Mailing Address
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Address Line | 200 W CRYSTAL CIR
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City | SHOW LOW
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State | AZ
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Zip | 85901-4791
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Country | US
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Telephone | 928-537-6700
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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 | 146N00000X
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Taxonomy Name | Basic Emergency Medical Technician
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License Number | E82309824
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 246W00000X
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Taxonomy Name | Cardiology Technician
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License Number |
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License Number State |
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