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NPI Code Detail

MEDICARE: DR. ERNEST THOMAS WILLIAMS JR. O.D.

MEDICARE: DR. ERNEST THOMAS WILLIAMS JR. O.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
1152W00000XOptometrist1568MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12111187OTHERMNMEDICA EYEGLASSES
24C990WIOTHERMNBC/BS EYEGLASS & CL
361443WIOTHERMNBLUE CROSS/BLUE SHIELD
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5170174OTHERMNUCARE
62200989OTHERMNMEDICA
7N005453OTHERMNCHAMPUS
801009882OTHERMNPREFERRED ONE
90313870001OTHERMND MERC
10111185OTHERMNUCARE EYEGLASSES

General Provider Information

NPI Number : 1255331427
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ERNEST THOMAS WILLIAMS JR. O.D.
Provider Business Mailing Address
First Line : 2932 1ST AVE
Second Line :
City : HIBBING
State : MN
Zip : 55746-2564
Country : US
Telephone Number : 218-262-5686
Fax Number : 218-263-6938
Provider Business Practice Location Address
First Line : 2932 1ST AVE
Second Line :
City : HIBBING
State : MN
Zip : 55746-2564
Country : US
Telephone Number : 218-262-5686
Fax Number : 218-263-6938
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2005
Last Update Date : 04/02/2013

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