Provider Demographics
NPI:1841886967
Name:CANDYCE WILLIAMS MD, P L C
Entity type:Organization
Organization Name:CANDYCE WILLIAMS MD, P L C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CANDYCE
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-806-7610
Mailing Address - Street 1:PO BOX 15667
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85060-5667
Mailing Address - Country:US
Mailing Address - Phone:602-806-7610
Mailing Address - Fax:602-704-6054
Practice Address - Street 1:444 W OSBORN RD STE 200
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-3817
Practice Address - Country:US
Practice Address - Phone:602-806-7610
Practice Address - Fax:602-704-6005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-13
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty