Provider Demographics
NPI:1720026651
Name:DAVID A. WILLIAMS, D.O., INC.
Entity Type:Organization
Organization Name:DAVID A. WILLIAMS, D.O., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ALBERT
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:JR
Authorized Official - Credentials:DO
Authorized Official - Phone:814-724-8024
Mailing Address - Street 1:600 WESLEY WAY
Mailing Address - Street 2:
Mailing Address - City:MEADVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16335-9413
Mailing Address - Country:US
Mailing Address - Phone:814-724-8024
Mailing Address - Fax:814-337-8635
Practice Address - Street 1:1015 GROVE ST
Practice Address - Street 2:
Practice Address - City:MEADVILLE
Practice Address - State:PA
Practice Address - Zip Code:16335-2944
Practice Address - Country:US
Practice Address - Phone:814-724-8024
Practice Address - Fax:814-337-8635
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS013026207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty