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General NPI Number Information
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NPI Number | 1679653208
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Entity Type | Individual
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Provider Name | JULIE KRISTINA WILLIAMS OD
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Gender | Female
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 111 WASHINGTON AVE WAGNER INDIAN HEALTH SERVICES
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City | WAGNER
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State | SD
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Zip | 57380
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Country | US
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Telephone | 605-384-3621
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Fax | 605-384-5975
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Provider Business Mailing Address
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Address Line | PO BOX 117
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City | WAGNER
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State | SD
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Zip | 57380-0117
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Country | US
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Telephone | 605-384-3555
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 02309
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 3000
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 607
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License Number State | SD
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Taxonomy #4
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 1233
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License Number State | NE
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