Provider Demographics
NPI:1972771020
Name:WILLIAMS, EMILY ELIZABETH (PA-C)
Entity Type:Individual
Prefix:MS
First Name:EMILY
Middle Name:ELIZABETH
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:ELIZABETH
Other - Last Name:MALLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:200 HAWKINS DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1009
Mailing Address - Country:US
Mailing Address - Phone:319-384-7898
Mailing Address - Fax:319-384-0603
Practice Address - Street 1:201 S CLINTON ST STE 168
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240-4034
Practice Address - Country:US
Practice Address - Phone:319-384-7898
Practice Address - Fax:319-384-0603
Is Sole Proprietor?:No
Enumeration Date:2008-02-12
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001836363A00000X, 363AM0700X
IL085003198363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL8122859OtherBCBS OF ILLINOIS
IA1932193224Medicaid
IA16-1801OtherMEDICARE UGS GROUP #
IL1972771020Medicaid
IA13238OtherWELLMARK BCBS OF IA
IA161935OtherHEALTH ALLIANCE
1932193224OtherCLINIC NPI
IA1972771020OtherBC/BS OF IOWA INDIVIDUAL
IL421060724002Medicaid
1932193224OtherCLINIC NPI
IL8122859OtherBCBS OF ILLINOIS
IL1972771020Medicaid