Provider Demographics
NPI:1518310903
Name:WILLIAMS, THOMAS CALEB (LHIS)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:CALEB
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:LHIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1180 CROSS CREEK DR
Mailing Address - Street 2:
Mailing Address - City:SALTILLO
Mailing Address - State:MS
Mailing Address - Zip Code:38866-5777
Mailing Address - Country:US
Mailing Address - Phone:662-842-4345
Mailing Address - Fax:662-205-4377
Practice Address - Street 1:1180 CROSS CREEK DR
Practice Address - Street 2:
Practice Address - City:SALTILLO
Practice Address - State:MS
Practice Address - Zip Code:38866-5777
Practice Address - Country:US
Practice Address - Phone:662-842-4345
Practice Address - Fax:662-205-4377
Is Sole Proprietor?:No
Enumeration Date:2016-07-20
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSHA0609237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist