Provider Demographics
NPI:1356398655
Name:DR. LINDA FISHER-WILLIAMS, D.O.
Entity type:Organization
Organization Name:DR. LINDA FISHER-WILLIAMS, D.O.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:L
Authorized Official - Last Name:FISHER-WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:517-694-2316
Mailing Address - Street 1:PO BOX 324
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48895-0324
Mailing Address - Country:US
Mailing Address - Phone:517-694-2316
Mailing Address - Fax:517-694-8177
Practice Address - Street 1:4801 WILLOUGHBY RD
Practice Address - Street 2:
Practice Address - City:HOLT
Practice Address - State:MI
Practice Address - Zip Code:48842-1000
Practice Address - Country:US
Practice Address - Phone:517-694-2316
Practice Address - Fax:517-694-8177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MILF008410207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0153311305OtherBCBSM
MILF008410OtherLICENSE NUMBER
MI5331014Medicare ID - Type Unspecified
MIF10823Medicare UPIN