Provider Demographics
NPI:1184935041
Name:WILLIAMS, HOLLY MARIE (MD)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:MARIE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 SOUTH 15TH STREET
Mailing Address - Street 2:
Mailing Address - City:WORLAND
Mailing Address - State:WY
Mailing Address - Zip Code:82401
Mailing Address - Country:US
Mailing Address - Phone:307-347-5810
Mailing Address - Fax:307-347-5808
Practice Address - Street 1:400 SOUTH 15TH STREET
Practice Address - Street 2:
Practice Address - City:WORLAND
Practice Address - State:WY
Practice Address - Zip Code:82401
Practice Address - Country:US
Practice Address - Phone:307-347-5810
Practice Address - Fax:307-347-5808
Is Sole Proprietor?:No
Enumeration Date:2010-06-25
Last Update Date:2021-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5520946-1205207P00000X
IDMC-1197207P00000X
MI4301096216207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine