Provider Demographics
NPI:1295537355
Name:WILLIAMS, CHARLES (PHLEBOTOMIST)
Entity type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:
Credentials:PHLEBOTOMIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6208 MEADOWLARK DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46226-3615
Mailing Address - Country:US
Mailing Address - Phone:317-744-4504
Mailing Address - Fax:
Practice Address - Street 1:5917 MASSACHUSETTS AVE APT D
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46218-2564
Practice Address - Country:US
Practice Address - Phone:317-744-4504
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-26
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN2646202C00000X, 246RP1900X
IN247ZC0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy
No202C00000XAllopathic & Osteopathic PhysiciansIndependent Medical Examiner
No247ZC0005XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyClinical Laboratory Director, Non-physician