Provider Demographics
NPI:1205116423
Name:WILLIAMS, LINDA PHAN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:PHAN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3269 STOCKTON HILL RD
Mailing Address - Street 2:PHARMACY DEPARTMENT
Mailing Address - City:KINGMAN
Mailing Address - State:AZ
Mailing Address - Zip Code:86409-3619
Mailing Address - Country:US
Mailing Address - Phone:928-757-0618
Mailing Address - Fax:928-692-4141
Practice Address - Street 1:1739 E BEVERLY AVE
Practice Address - Street 2:STE 107
Practice Address - City:KINGMAN
Practice Address - State:AZ
Practice Address - Zip Code:86409-3593
Practice Address - Country:US
Practice Address - Phone:928-681-8738
Practice Address - Fax:928-681-8739
Is Sole Proprietor?:No
Enumeration Date:2011-08-18
Last Update Date:2015-02-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI5302038284183500000X
AZS019527183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist