Provider Demographics
NPI:1952697468
Name:WILLIAMS, ELIZABETH HART MAHON (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:HART MAHON
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:615 S NEW BALLAS RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8221
Mailing Address - Country:US
Mailing Address - Phone:314-251-5834
Mailing Address - Fax:314-251-6272
Practice Address - Street 1:615 S NEW BALLAS RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8221
Practice Address - Country:US
Practice Address - Phone:314-251-5834
Practice Address - Fax:314-251-6272
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-22
Last Update Date:2014-01-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2011014989207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine