Provider Demographics
NPI:1790505337
Name:WILLIAMS, STEVEN (PHARMACIST)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:PHARMACIST
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 361
Mailing Address - Street 2:
Mailing Address - City:CLEARFIELD
Mailing Address - State:KY
Mailing Address - Zip Code:40313-0361
Mailing Address - Country:US
Mailing Address - Phone:606-253-1266
Mailing Address - Fax:
Practice Address - Street 1:1822 MAIN ST
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:KY
Practice Address - Zip Code:40361-1109
Practice Address - Country:US
Practice Address - Phone:859-900-0330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-16
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY010287183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist