Provider Demographics
NPI:1083945257
Name:WILLIAMS, ALLISON RUTH (PA)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:RUTH
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 11314
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4004
Mailing Address - Country:US
Mailing Address - Phone:757-842-4481
Mailing Address - Fax:757-312-3135
Practice Address - Street 1:534 CARATOKE HWY
Practice Address - Street 2:
Practice Address - City:MOYOCK
Practice Address - State:NC
Practice Address - Zip Code:27958
Practice Address - Country:US
Practice Address - Phone:252-435-6621
Practice Address - Fax:252-435-2685
Is Sole Proprietor?:No
Enumeration Date:2010-01-27
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0110003219363A00000X
NC0010-02182363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant