Provider Demographics
NPI:1083815393
Name:WILLIAMS, DERRICK A (MD)
Entity Type:Individual
Prefix:DR
First Name:DERRICK
Middle Name:A
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:13914 SOUTHEASTERN PKWY
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46037-7127
Mailing Address - Country:US
Mailing Address - Phone:317-415-9900
Mailing Address - Fax:317-415-9910
Practice Address - Street 1:13914 SOUTHEASTERN PARKWAY
Practice Address - Street 2:SUITE 210
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46037
Practice Address - Country:US
Practice Address - Phone:317-419-9900
Practice Address - Fax:317-415-9910
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01063841A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine