Provider Demographics
NPI:1093901118
Name:MICHAEL D WILLIAMS MD PA
Entity Type:Organization
Organization Name:MICHAEL D WILLIAMS MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:806-352-5888
Mailing Address - Street 1:6009 BELPREE RD
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-3302
Mailing Address - Country:US
Mailing Address - Phone:806-352-5888
Mailing Address - Fax:806-463-2891
Practice Address - Street 1:6009 BELPREE RD
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-3302
Practice Address - Country:US
Practice Address - Phone:806-352-5888
Practice Address - Fax:806-463-2891
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-21
Last Update Date:2007-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00Y074Medicare PIN