Provider Demographics
NPI:1275622722
Name:WILLIAMS, TODD (PA-C)
Entity Type:Individual
Prefix:MR
First Name:TODD
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:120 CREEKVISTA DR
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27540-6832
Mailing Address - Country:US
Mailing Address - Phone:910-494-6071
Mailing Address - Fax:919-567-2902
Practice Address - Street 1:3147 BIOINFORMATICS BUIL
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-0001
Practice Address - Country:US
Practice Address - Phone:919-966-9166
Practice Address - Fax:919-966-6730
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC0010-00391363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant