Provider Demographics
NPI:1568626349
Name:WILLIAMS, DANNIE E (MD)
Entity Type:Individual
Prefix:DR
First Name:DANNIE
Middle Name:E
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:DANNIE
Other - Middle Name:E
Other - Last Name:HOPSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:5621 DELMAR BLVD STE 108
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63112-2660
Mailing Address - Country:US
Mailing Address - Phone:314-833-3437
Mailing Address - Fax:314-584-5097
Practice Address - Street 1:9150 OVERLAND PLZ
Practice Address - Street 2:
Practice Address - City:OVERLAND
Practice Address - State:MO
Practice Address - Zip Code:63114-6123
Practice Address - Country:US
Practice Address - Phone:314-449-9633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-11
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP2083207Q00000X
MO2013013940207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine