Provider Demographics
NPI:1730789918
Name:WILLIAMS, PATRICIA ANN (PD)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ANN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 TARKINGTON DR
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-8983
Mailing Address - Country:US
Mailing Address - Phone:501-278-0666
Mailing Address - Fax:501-268-4949
Practice Address - Street 1:3509 E RACE AVE
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-6202
Practice Address - Country:US
Practice Address - Phone:501-268-4946
Practice Address - Fax:501-268-4949
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-28
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD06596183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist