MEDICARE: LILLIAN P WILLIAMS PA-C

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
1	363A00000X	Physician Assistant	PA17194	TX

General Provider Information

NPI Number	:	1174239693
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LILLIAN P WILLIAMS PA-C

Provider Business Mailing Address
First Line	:	111 EASTWIND DR
Second Line	:
City	:	OXFORD
State	:	MS
Zip	:	38655-8890
Country	:	US
Telephone Number	:	615-796-9517
Fax Number	:

Provider Business Practice Location Address
First Line	:	111 EASTWIND DR
Second Line	:
City	:	OXFORD
State	:	MS
Zip	:	38655-8890
Country	:	US
Telephone Number	:	615-796-9517
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/27/2023
Last Update Date	:	03/03/2026

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