Provider Demographics
NPI:1184805525
Name:WILLIAMS, KARL S JR (SA)
Entity type:Individual
Prefix:MR
First Name:KARL
Middle Name:S
Last Name:WILLIAMS
Suffix:JR
Gender:M
Credentials:SA
Other - Prefix:MR
Other - First Name:KARL
Other - Middle Name:SAMUEL
Other - Last Name:WILLIAMS
Other - Suffix:JR
Other - Last Name Type:Professional Name
Other - Credentials:CSA
Mailing Address - Street 1:PO BOX 901
Mailing Address - Street 2:
Mailing Address - City:COLLEGE PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20741-0901
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9651 BALTIMORE AVE
Practice Address - Street 2:SUITE 200A
Practice Address - City:COLLEGE PARK
Practice Address - State:MD
Practice Address - Zip Code:20740-1305
Practice Address - Country:US
Practice Address - Phone:240-264-6835
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-14
Last Update Date:2014-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant