Doctor Name: | MRS. TIFFANY WILLIAMS |
NPI Number: | 1356753966 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | PA30147 |
Business Practice Address: | Old Hwy 75 Butner, NC - 27509 |
Business Phone Number: | 9195753900 |
Business Fax Number: | 9195754828 |
Mailing Address: | Old Hwy 75, BUTNER |
State: | NC |
Postal Code: | 27509 |
Phone Number: | 9195753900 |
Fax Number: | 9195754828 |
NPI Enumeration Date: | 05/30/2014 |
NPI Last Update Date: | 05/30/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | PA30147 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | DC |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |