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General NPI Number Information
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NPI Number | 1679620835
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Entity Type | Organization
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Legal Business Name | WILLIAMS MEDICAL CLINIC
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Dates
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Enumeration Date | 01/03/2007
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Last Update Date | 04/23/2008
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Provider Practice Location Address
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Address Line | 403E MORROW ST N
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City | MENA
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State | AR
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Zip | 71953-4317
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Country | US
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Telephone | 479-243-9024
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Fax | 479-243-9248
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Provider Business Mailing Address
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Address Line | PO BOX 295
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City | LOCKESBURG
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State | AR
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Zip | 71846-0295
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Country | US
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Telephone | 870-289-5865
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Fax | 870-289-6993
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Authorized Official
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Title or Position | OWNER
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Name | ROBERT S. WILLIAMS
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Credential | M.D.
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Telephone | 479-243-9024
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | E2014
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License Number State | AR
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