Provider Demographics
NPI:1255734182
Name:WILLIAMS, HEATH TYRONE
Entity type:Individual
Prefix:MR
First Name:HEATH
Middle Name:TYRONE
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 E NORTHERN AVE
Mailing Address - Street 2:2009
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-4161
Mailing Address - Country:US
Mailing Address - Phone:480-593-5452
Mailing Address - Fax:
Practice Address - Street 1:3300 N CENTRAL AVE
Practice Address - Street 2:2550
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-2501
Practice Address - Country:US
Practice Address - Phone:602-256-2525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-06
Last Update Date:2014-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant