Provider Demographics
NPI:1326215112
Name:DANIEL G. WILLIAMS, D.O., P.L.L.C.
Entity Type:Organization
Organization Name:DANIEL G. WILLIAMS, D.O., P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:520-867-6156
Mailing Address - Street 1:1509 S BURNING TREE AVE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85710-7274
Mailing Address - Country:US
Mailing Address - Phone:520-867-6156
Mailing Address - Fax:
Practice Address - Street 1:800 N SWAN RD
Practice Address - Street 2:SUITE 128
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-1262
Practice Address - Country:US
Practice Address - Phone:520-867-6156
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-12
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5015204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMMGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ5015OtherSTATE LICENSE