Provider Demographics
NPI:1043216732
Name:WILLIAMS MD, ANN KATHERINE (MD)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:KATHERINE
Last Name:WILLIAMS MD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6850 HOHMAN AVENUE
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:IN
Mailing Address - Zip Code:46324-1410
Mailing Address - Country:US
Mailing Address - Phone:219-931-7509
Mailing Address - Fax:
Practice Address - Street 1:6850 HOHMAN AVE
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:IN
Practice Address - Zip Code:46324-1410
Practice Address - Country:US
Practice Address - Phone:219-931-7509
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-27
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01039204A207W00000X
IL036068962207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100465760Medicaid
IN100465760Medicaid
IN100465760Medicaid