Provider Demographics
NPI:1700908738
Name:WILLIAMS, DANIEL G (DO)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:G
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11011 TAM O'SHANTER DR
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:755 W CARMEL DR STE 211
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-5878
Practice Address - Country:US
Practice Address - Phone:317-819-4949
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5015204D00000X
OK4443204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
Provider Identifiers
StateIdentifier IDID TypeIssuer
INP01456958OtherRAIL ROAD PTAN
AZ5015OtherSTATE LICENSE
IN02004170AOtherIN STATE LICENSE
OK4443OtherSTATE LICENSE
OK4443OtherSTATE LICENSE