Provider Demographics
NPI:1205929262
Name:WILLIAMS, CHARLES DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:DAVID
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9601 BAPTIST HEALTH DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-6321
Mailing Address - Country:US
Mailing Address - Phone:501-224-5666
Mailing Address - Fax:501-228-2007
Practice Address - Street 1:9601 BAPTIST HEALTH DR
Practice Address - Street 2:SUITE 200
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6321
Practice Address - Country:US
Practice Address - Phone:501-224-5666
Practice Address - Fax:501-228-2007
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2020-06-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ARC 3382208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR104535001Medicaid
ARD17180Medicare UPIN
AR55690Medicare ID - Type UnspecifiedMEDICARE #