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General NPI Number Information
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NPI Number | 1720179997
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Entity Type | Individual
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Provider Name | CHANDRA M WILLIAMS O.D.
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Gender | Female
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 02/17/2024
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Provider Practice Location Address
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Address Line | 13453 N MAIN ST STE 203
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City | JACKSONVILLE
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State | FL
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Zip | 32218-2773
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Country | US
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Telephone | 904-696-2027
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Fax | 904-696-2028
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Provider Business Mailing Address
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Address Line | 13453 N MAIN ST STE 203
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City | JACKSONVILLE
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State | FL
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Zip | 32218-2773
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Country | US
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Telephone | 904-696-2027
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Fax | 904-696-2028
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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 | OEG001840
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License Number State | FL
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