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1255541561

NPI Code Detail

MEDICARE: DR. LASHONDA LASHAY WILLIAMS M.D.

MEDICARE: DR. LASHONDA LASHAY 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	208600000X	Surgery Physician	P1152	TX
2	208600000X	Surgery Physician	01077922A	IN
3	2086S0127X	Trauma Surgery Physician	EMC0003431	MI
4	390200000X	Student in an Organized Health Care Education/Training Program
5	208600000X	Surgery Physician	200776	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	8CZ472	OTHER	TX	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1255541561
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LASHONDA LASHAY WILLIAMS M.D.

Provider Business Mailing Address
First Line	:	3702 NEW VISION DR BLDG B
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46845-1703
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1521 GULL RD
Second Line	:
City	:	KALAMAZOO
State	:	MI
Zip	:	49048-1640
Country	:	US
Telephone Number	:	269-226-7917
Fax Number	:

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

Provider Enumeration Date	:	05/23/2007
Last Update Date	:	03/08/2026

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Directions to “ DR. LASHONDA LASHAY WILLIAMS M.D.” Practice Location

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