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NPI Code Detail

MEDICARE: ANGELA MARIE WILLIAMS BS

MEDICARE: ANGELA MARIE WILLIAMS BS
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1649417270
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELA MARIE WILLIAMS BS
Provider Business Mailing Address
First Line : 426 E G ST
Second Line :
City : ELIZABETHTON
State : TN
Zip : 37643-3224
Country : US
Telephone Number : 423-547-5950
Fax Number : 423-467-3644
Provider Business Practice Location Address
First Line : 1167 SPRATLIN PARK DR
Second Line :
City : GRAY
State : TN
Zip : 37615-6205
Country : US
Telephone Number : 423-467-3721
Fax Number : 423-467-3644
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/20/2009
Last Update Date : 01/20/2009

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