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General NPI Number Information
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NPI Number | 1912120080
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Entity Type | Individual
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Provider Name | PHILLIP A WILLIAMS O.D.
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Gender | Male
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2301 S HARPER RD
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City | CORINTH
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State | MS
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Zip | 38834-6771
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Country | US
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Telephone | 662-287-1297
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Fax |
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Provider Business Mailing Address
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Address Line | 3904 CEDAR CREEK DR
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City | CORINTH
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State | MS
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Zip | 38834-9693
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Country | US
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Telephone | 662-287-1061
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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 | 613
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License Number State | MS
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