Provider Demographics
NPI:1972579266
Name:WILLIAMS, DEBORAH L (MD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:L
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1115 RONALD REAGAN PKWY
Mailing Address - Street 2:SUITE 266
Mailing Address - City:AVON
Mailing Address - State:IN
Mailing Address - Zip Code:46123-6910
Mailing Address - Country:US
Mailing Address - Phone:317-209-2000
Mailing Address - Fax:317-209-2010
Practice Address - Street 1:1115 RONALD REAGAN PKWY
Practice Address - Street 2:SUITE 266
Practice Address - City:AVON
Practice Address - State:IN
Practice Address - Zip Code:46123-6910
Practice Address - Country:US
Practice Address - Phone:317-209-2000
Practice Address - Fax:317-209-2010
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2012-05-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01029578A207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100451810Medicaid
IN160031994Medicare PIN
INC25986Medicare UPIN
IN100451810Medicaid