MEDICARE: DR. PHILIP THOMAS WILLIAMS 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
1	152W00000X	Optometrist	1527TX	WA

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

General Provider Information

NPI Number	:	1467459511
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PHILIP THOMAS WILLIAMS O.D.

Provider Business Mailing Address
First Line	:	17432 SMOKEY POINT BLVD
Second Line	:	SUITE #102
City	:	ARLINGTON
State	:	WA
Zip	:	98223-8784
Country	:	US
Telephone Number	:	360-653-3305
Fax Number	:	360-658-0812

Provider Business Practice Location Address
First Line	:	17432 SMOKEY POINT BLVD
Second Line	:	SUITE #102
City	:	ARLINGTON
State	:	WA
Zip	:	98223-8784
Country	:	US
Telephone Number	:	360-653-3305
Fax Number	:	360-658-0812

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

Provider Enumeration Date	:	07/05/2005
Last Update Date	:	02/09/2018

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