Basic Information
Provider Information
NPI: 1518387638
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WILLIAMS
FirstName: EMILY
MiddleName: MIDDLETON
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4301 W MARKHAM ST
Address2:  
City: LITTLE ROCK
State: AR
PostalCode: 722057101
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 5002 COWHORN CREEK RD
Address2:  
City: TEXARKANA
State: TX
PostalCode: 75503
CountryCode: US
TelephoneNumber: 9036143000
FaxNumber: 9036143525
Other Information
ProviderEnumerationDate: 04/16/2014
LastUpdateDate: 07/03/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000XR8133TXY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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