Provider Demographics
NPI:1750345443
Name:WILLIAMS, THOMAS REGINALD (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:REGINALD
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MD
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 3445
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28603-3445
Mailing Address - Country:US
Mailing Address - Phone:828-322-2050
Mailing Address - Fax:828-345-0522
Practice Address - Street 1:2424 CENTURY PL SE
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-4031
Practice Address - Country:US
Practice Address - Phone:828-322-2050
Practice Address - Fax:828-322-5858
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9501152174400000X, 207WX0107X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No174400000XOther Service ProvidersSpecialist
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC11605241OtherCAQH
NC1750345443Medicaid
NC5044012OtherENVOLVE
NC5044012OtherAETNA
NC87948OtherBCBS
NC1853359OtherWELLCARE
NCA03462OtherEYEMED