Provider Demographics
NPI:1215185863
Name:WILLIAMS, LAUREN PARRISH (OD)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:PARRISH
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3460 TEN TEN RD 112
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-6303
Mailing Address - Country:US
Mailing Address - Phone:919-367-5555
Mailing Address - Fax:
Practice Address - Street 1:1829 DOCTORS DR
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-5067
Practice Address - Country:US
Practice Address - Phone:919-776-2032
Practice Address - Fax:919-775-2179
Is Sole Proprietor?:No
Enumeration Date:2008-09-08
Last Update Date:2015-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2127152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5912511Medicaid