Provider Demographics
NPI:1295394781
Name:WILLIAMS, OLIVIA PAYTON (N/A)
Entity Type:Individual
Prefix:MS
First Name:OLIVIA
Middle Name:PAYTON
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:N/A
Other - Prefix:
Other - First Name:OLIVIA
Other - Middle Name:PAYTON
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:N/A
Mailing Address - Street 1:32100 TELEGRAPH RD
Mailing Address - Street 2:
Mailing Address - City:BINGHAM FARMS
Mailing Address - State:MI
Mailing Address - Zip Code:48025-2452
Mailing Address - Country:US
Mailing Address - Phone:734-353-2907
Mailing Address - Fax:
Practice Address - Street 1:19853 OUTER DR
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-2066
Practice Address - Country:US
Practice Address - Phone:248-621-4792
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-10
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156F00000XEye and Vision Services ProvidersTechnician/Technologist