Provider Demographics
NPI:1760498240
Name:WILLIAMS, ACKERMAN CLAUDE JR (MD)
Entity Type:Individual
Prefix:DR
First Name:ACKERMAN
Middle Name:CLAUDE
Last Name:WILLIAMS
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:994 VALLAMONT DRIVE
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSPORT
Mailing Address - State:PA
Mailing Address - Zip Code:17701-3050
Mailing Address - Country:US
Mailing Address - Phone:570-323-4677
Mailing Address - Fax:570-322-2812
Practice Address - Street 1:994 VALLAMONT DRIVE
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701-3050
Practice Address - Country:US
Practice Address - Phone:570-323-4677
Practice Address - Fax:570-322-2812
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2013-02-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD013316E2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA441261722OtherRR MEDICARE-PALMETTO GBA
PA441261722OtherRR MEDICARE-PALMETTO GBA
C26039Medicare UPIN