Provider Demographics
NPI:1992391791
Name:WILLIAMS, AMERICUS H (LAT, ATC)
Entity Type:Individual
Prefix:
First Name:AMERICUS
Middle Name:H
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3240 BRIERHILL RD
Mailing Address - Street 2:
Mailing Address - City:NEW HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27562-9360
Mailing Address - Country:US
Mailing Address - Phone:252-452-3766
Mailing Address - Fax:
Practice Address - Street 1:2817 REILLY ST
Practice Address - Street 2:
Practice Address - City:FORT BRAGG
Practice Address - State:NC
Practice Address - Zip Code:28310
Practice Address - Country:US
Practice Address - Phone:910-907-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-15
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLAT-32172255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer