Provider Demographics
NPI:1083830079
Name:WILLIAMS, PATRICIA FERN (R MR)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:FERN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:R MR
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4650 UTAH TRL
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72034-3380
Mailing Address - Country:US
Mailing Address - Phone:501-690-0745
Mailing Address - Fax:
Practice Address - Street 1:2585 DONAGHEY AVE
Practice Address - Street 2:STE 109
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72032-2327
Practice Address - Country:US
Practice Address - Phone:501-764-1201
Practice Address - Fax:501-764-1204
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARRT4627247100000X
3426642471M1202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic Technologist
Not Answered2471M1202XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistMagnetic Resonance Imaging