Provider Demographics
NPI:1013935410
Name:WILLIAMS, DAVID M (PT)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:M
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1585 EAGLE VIEW CT NW
Mailing Address - Street 2:
Mailing Address - City:SWISHER
Mailing Address - State:IA
Mailing Address - Zip Code:52338-9437
Mailing Address - Country:US
Mailing Address - Phone:319-936-5836
Mailing Address - Fax:319-625-3032
Practice Address - Street 1:2590 HOLIDAY RD STE 10
Practice Address - Street 2:
Practice Address - City:CORALVILLE
Practice Address - State:IA
Practice Address - Zip Code:52241-2815
Practice Address - Country:US
Practice Address - Phone:319-625-3030
Practice Address - Fax:319-625-3032
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA02935208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA12426OtherWELLMARK BCBS
IAF232553OtherMIDLANDS CHOICE
IA0429001Medicaid
IAI10845Medicare ID - Type Unspecified