Provider Demographics
NPI:1659836328
Name:WILLIAMS, ANTHONY JR
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:
Last Name:WILLIAMS
Suffix:JR
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 1:605 ATLANTIC ST SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032-3738
Mailing Address - Country:US
Mailing Address - Phone:202-717-7197
Mailing Address - Fax:
Practice Address - Street 1:1610 16TH ST SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-5504
Practice Address - Country:US
Practice Address - Phone:202-717-7197
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-06
Last Update Date:2019-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant