Provider Demographics
NPI:1801847322
Name:WILLIAMS, CALVIN EDWARD JR (MD)
Entity Type:Individual
Prefix:DR
First Name:CALVIN
Middle Name:EDWARD
Last Name:WILLIAMS
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:8030 CROWDER BLVD.
Mailing Address - Street 2:SUITE A
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70127
Mailing Address - Country:US
Mailing Address - Phone:504-241-2220
Mailing Address - Fax:504-241-2202
Practice Address - Street 1:8030 CROWDER BLVD.
Practice Address - Street 2:SUITE A
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70127
Practice Address - Country:US
Practice Address - Phone:504-241-2220
Practice Address - Fax:504-241-2202
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-12
Last Update Date:2018-02-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA019972208600000X
LA19972208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1992836Medicaid
LA1992836Medicaid