MEDICARE: MRS. EMILY ANNE WILLIAMS M.D.

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	207P00000X	Emergency Medicine Physician	E-9781	AR
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1174814727
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. EMILY ANNE WILLIAMS M.D.

Provider Business Mailing Address
First Line	:	7301 ROGERS AVE
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72903-4100
Country	:	US
Telephone Number	:	479-314-6000
Fax Number	:

Provider Business Practice Location Address
First Line	:	2901 S 74TH ST
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72903-5156
Country	:	US
Telephone Number	:	479-314-1101
Fax Number	:	479-314-4704

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

Provider Enumeration Date	:	04/29/2011
Last Update Date	:	11/02/2016

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