Provider Demographics
NPI:1669524278
Name:WILLIAMS, ANN AUSTIN (O D)
Entity type:Individual
Prefix:DR
First Name:ANN
Middle Name:AUSTIN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:O D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1508
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39403-1508
Mailing Address - Country:US
Mailing Address - Phone:601-545-2020
Mailing Address - Fax:601-583-0120
Practice Address - Street 1:600 W PINE ST
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39401-3834
Practice Address - Country:US
Practice Address - Phone:601-545-2020
Practice Address - Fax:601-583-0120
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2014-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS508152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00087064Medicaid
MS0360420001Medicare NSC
MS410000037Medicare PIN
MST93630Medicare UPIN
MSC00584Medicare PIN
MS540017775Medicare PIN