Provider Demographics
NPI:1942525746
Name:WILLIAMS, FRANK JR
Entity Type:Individual
Prefix:
First Name:FRANK
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:PO BOX 9177
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71211-9177
Mailing Address - Country:US
Mailing Address - Phone:318-574-0098
Mailing Address - Fax:318-574-0066
Practice Address - Street 1:604 KIMBROUGH BLVD BLDG Q
Practice Address - Street 2:
Practice Address - City:TALLULAH
Practice Address - State:LA
Practice Address - Zip Code:71282-5420
Practice Address - Country:US
Practice Address - Phone:318-574-0098
Practice Address - Fax:318-574-0066
Is Sole Proprietor?:No
Enumeration Date:2010-04-05
Last Update Date:2010-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver