Provider Demographics
NPI:1366719056
Name:WILLIAMS, CARL HILTON
Entity type:Individual
Prefix:MR
First Name:CARL
Middle Name:HILTON
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1957 N ARDENWOOD DR
Mailing Address - Street 2:APT 6072
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-1632
Mailing Address - Country:US
Mailing Address - Phone:225-246-2449
Mailing Address - Fax:225-246-2449
Practice Address - Street 1:1957 N ARDENWOOD DR
Practice Address - Street 2:APT 6072
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-1632
Practice Address - Country:US
Practice Address - Phone:225-246-2449
Practice Address - Fax:225-246-2449
Is Sole Proprietor?:No
Enumeration Date:2011-11-23
Last Update Date:2011-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA103K00000X103K00000X
LA146N00000X146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic