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General NPI Number Information
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NPI Number | 1992270862
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Entity Type | Organization
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Legal Business Name | MICHAEL A. WILLIAMS, OD, SC
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Dates
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Enumeration Date | 10/08/2018
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Last Update Date | 10/08/2018
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Provider Practice Location Address
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Address Line | 1040 COLLINSVILLE CROSSING BLVD
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City | COLLINSVILLE
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State | IL
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Zip | 62234-1882
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Country | US
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Telephone | 618-343-1508
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Fax | 618-343-2083
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Provider Business Mailing Address
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Address Line | 1040 COLLINSVILLE CROSSING BLVD
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City | COLLINSVILLE
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State | IL
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Zip | 62234-1882
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Country | US
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Telephone | 618-343-1508
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Fax | 618-343-2083
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. MICHAEL A WILLIAMS
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Credential | OD
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Telephone | 618-407-4260
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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 |
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License Number State |
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