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NPI Code Detail

MEDICARE: MR. HENRY WILLIAMS

MEDICARE:  MR. HENRY  WILLIAMS
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
1172A00000XDriver25-262WI

General Provider Information

NPI Number : 1366397895
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. HENRY WILLIAMS
Provider Business Mailing Address
First Line : 3003 WILSON ST NE LOT 47
Second Line :
City : MENOMONIE
State : WI
Zip : 54751-1056
Country : US
Telephone Number : 715-308-9030
Fax Number :
Provider Business Practice Location Address
First Line : 3003 WILSON ST NE LOT 47
Second Line :
City : MENOMONIE
State : WI
Zip : 54751-1056
Country : US
Telephone Number : 715-308-9030
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/02/2026
Last Update Date : 03/02/2026

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Directions to “ MR. HENRY WILLIAMS ” Practice Location

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