Provider Demographics
NPI:1376732305
Name:WILLIAMS, CASEY DEAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CASEY
Middle Name:DEAN
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38529 HIGHWAY 67
Mailing Address - Street 2:
Mailing Address - City:DONALDSON
Mailing Address - State:AR
Mailing Address - Zip Code:71941-8217
Mailing Address - Country:US
Mailing Address - Phone:501-384-5499
Mailing Address - Fax:
Practice Address - Street 1:2800 PINE ST
Practice Address - Street 2:#5 PINE PLAZA
Practice Address - City:ARKADELPHIA
Practice Address - State:AR
Practice Address - Zip Code:71923-5321
Practice Address - Country:US
Practice Address - Phone:870-246-2015
Practice Address - Fax:870-246-2915
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-16
Last Update Date:2008-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD08798183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist