Provider Demographics
NPI:1669738076
Name:WILLIAMS CHIROPRACTIC CARE
Entity type:Organization
Organization Name:WILLIAMS CHIROPRACTIC CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:501-227-9766
Mailing Address - Street 1:1200 BARROW RD
Mailing Address - Street 2:SUITE 112
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-6500
Mailing Address - Country:US
Mailing Address - Phone:501-227-9766
Mailing Address - Fax:
Practice Address - Street 1:8703 KANIS RD
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72204-2323
Practice Address - Country:US
Practice Address - Phone:501-227-9766
Practice Address - Fax:501-227-7290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-10
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1568111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR146751718Medicaid
AR5W488Medicaid