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NPI Code Detail

MEDICARE: CANDYCE WILLIAMS MD

MEDICARE: CANDYCE WILLIAMS MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician21064AZ
2225400000XRehabilitation Practitioner21064AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1114991155
Entity Type Code : Individual
Provider Name (Legal Business Name) : CANDYCE WILLIAMS MD
Provider Business Mailing Address
First Line : PO BOX 15667
Second Line :
City : PHOENIX
State : AZ
Zip : 85060-5667
Country : US
Telephone Number : 602-806-7610
Fax Number : 602-704-6054
Provider Business Practice Location Address
First Line : 444 W OSBORN RD STE 200
Second Line :
City : PHOENIX
State : AZ
Zip : 85013-3817
Country : US
Telephone Number : 602-806-7610
Fax Number : 602-704-6054
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/15/2006
Last Update Date : 06/10/2021

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