Provider Demographics
NPI:1457478174
Name:WILLIAMS, RICHARD PAUL
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:PAUL
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 1:122 E RUSH AVE
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:AR
Mailing Address - Zip Code:72601-4326
Mailing Address - Country:US
Mailing Address - Phone:870-743-4916
Mailing Address - Fax:870-280-1962
Practice Address - Street 1:122 E RUSH AVE
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:AR
Practice Address - Zip Code:72601-4326
Practice Address - Country:US
Practice Address - Phone:870-743-4916
Practice Address - Fax:870-280-1962
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3596111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN350001991Medicare ID - Type Unspecified