=====================================================
General NPI Number Information
=====================================================
NPI Number | 1871765438
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | KATHERINE L. WILLIAMS, MD APMC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/24/2008
-----------------------------------------------------
Last Update Date | 03/24/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 606 W 12TH AVE
-----------------------------------------------------
City | COVINGTON
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70433-3358
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 985-249-7022
-----------------------------------------------------
Fax | 985-249-7048
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 606 W 12TH AVE
-----------------------------------------------------
City | COVINGTON
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70433-3358
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 985-249-7022
-----------------------------------------------------
Fax | 985-249-7048
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRACTICE MANAGER
-----------------------------------------------------
Name | MRS. NICHOLE M KEATING
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 985-249-7022
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | 022401
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------