Provider Demographics
NPI:1194956292
Name:MARGOT A. WILLIAMS, D.O., P.C.
Entity type:Organization
Organization Name:MARGOT A. WILLIAMS, D.O., P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARGOT
Authorized Official - Middle Name:A
Authorized Official - Last Name:CROSSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:719-266-5944
Mailing Address - Street 1:6965 TUTT BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80923-3597
Mailing Address - Country:US
Mailing Address - Phone:719-266-5944
Mailing Address - Fax:
Practice Address - Street 1:6965 TUTT BLVD STE 100
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80923
Practice Address - Country:US
Practice Address - Phone:719-266-5944
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-06
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO34758208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1992456461Medicaid
CO1568124493Medicaid
CO1477204758Medicaid
CO1659919785Medicaid