Provider Demographics
NPI:1952999021
Name:WILLIAMS, ALLIE (PHARMD)
Entity Type:Individual
Prefix:
First Name:ALLIE
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1417 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42629-2411
Mailing Address - Country:US
Mailing Address - Phone:270-343-4443
Mailing Address - Fax:270-343-4481
Practice Address - Street 1:1417 N MAIN ST
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:KY
Practice Address - Zip Code:42629-2411
Practice Address - Country:US
Practice Address - Phone:270-343-4443
Practice Address - Fax:270-343-4481
Is Sole Proprietor?:No
Enumeration Date:2021-01-05
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY018654183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist