Basic Information
| Provider Information | |||||||||
| NPI: | 1316927981 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WILLIAMS | ||||||||
| FirstName: | DEBRA | ||||||||
| MiddleName: | MOMILANI | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1650 COCHRANE CIR CREDENTIALS OFFICE | ||||||||
| Address2: | EVANS ARMY COMMUNITY HOSPITAL (EACH) USA MEDDAC | ||||||||
| City: | FORT CARSON | ||||||||
| State: | CO | ||||||||
| PostalCode: | 809134604 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7195267844 | ||||||||
| FaxNumber: | 7195267984 | ||||||||
| Practice Location | |||||||||
| Address1: | EVANS ARMY COMMUNITY HOSPITAL (EACH) USA MEDDAC | ||||||||
| Address2: | EACH PEDIATRIC CLINIC ROOM #1221 | ||||||||
| City: | FORT CARSON | ||||||||
| State: | CO | ||||||||
| PostalCode: | 809134604 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7195267653 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/19/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 0101054457 | VA | X | Allopathic & Osteopathic Physicians | Pediatrics | 208000000X | MD-9978 | HI | X | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.