Provider Demographics
NPI:1235820606
Name:WILLIAMS, DEVON ALLAN
Entity Type:Individual
Prefix:
First Name:DEVON
Middle Name:ALLAN
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1306 NEW TOWN AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-8024
Mailing Address - Country:US
Mailing Address - Phone:412-735-6801
Mailing Address - Fax:
Practice Address - Street 1:211 SOUTH AVE STE C
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32508-5116
Practice Address - Country:US
Practice Address - Phone:850-361-7426
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-17
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical Technicians
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic