Provider Demographics
NPI:1306566971
Name:WILLIAMS, CHUCK EUGENE (PD)
Entity type:Individual
Prefix:MR
First Name:CHUCK
Middle Name:EUGENE
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:PD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 GOLF COURSE DR
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-4862
Mailing Address - Country:US
Mailing Address - Phone:501-268-5540
Mailing Address - Fax:501-268-5338
Practice Address - Street 1:700 GOLF COURSE DR
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-4862
Practice Address - Country:US
Practice Address - Phone:501-268-5540
Practice Address - Fax:501-268-5338
Is Sole Proprietor?:No
Enumeration Date:2022-09-01
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD07245183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR126682407Medicaid