Provider Demographics
NPI:1831478973
Name:MCWILLIAMS, BRITTNEY (OD)
Entity Type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:
Last Name:MCWILLIAMS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7144 E VIRGINIA ST
Mailing Address - Street 2:STE A
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47715-9125
Mailing Address - Country:US
Mailing Address - Phone:812-473-6080
Mailing Address - Fax:
Practice Address - Street 1:7144 E VIRGINIA ST
Practice Address - Street 2:STE A
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-9125
Practice Address - Country:US
Practice Address - Phone:812-473-6080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-08
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18003684A152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201041680Medicaid