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General NPI Number Information
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NPI Number | 1942793294
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Entity Type | Individual
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Provider Name | DEREK WILLIAMS OD
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Gender | Male
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Dates
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Enumeration Date | 06/12/2018
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Last Update Date | 04/12/2021
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Provider Practice Location Address
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Address Line | 1522 JANES AVE
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City | SAGINAW
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State | MI
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Zip | 48601-1819
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Country | US
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Telephone | 989-907-2790
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Fax | 989-399-8263
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Provider Business Mailing Address
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Address Line | 4123 WORTH RD
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City | PINCONNING
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State | MI
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Zip | 48650-8316
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Country | US
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Telephone | 989-313-1006
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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 | 4901005110
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License Number State | MI
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