Provider Demographics
NPI:1902855794
Name:WILLIAMS, AMY H (MD)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:H
Last Name:WILLIAMS
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2818 ROCK MERRITT AVE
Mailing Address - Street 2:
Mailing Address - City:FORT BRAGG
Mailing Address - State:NC
Mailing Address - Zip Code:28310-0001
Mailing Address - Country:US
Mailing Address - Phone:910-907-8922
Mailing Address - Fax:910-907-6069
Practice Address - Street 1:2818 ROCK MERRITT AVE
Practice Address - Street 2:
Practice Address - City:FORT BRAGG
Practice Address - State:NC
Practice Address - Zip Code:28310-0001
Practice Address - Country:US
Practice Address - Phone:910-907-8922
Practice Address - Fax:910-907-6069
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC24876207P00000X
TXN4842207P00000X
NC2010-01135207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1902855794OtherTRICARE SOUTH
TX8CE254OtherBCBS TX
TX1902855794OtherBCBSTX
GA218875878AMedicaid
TX208104401Medicaid
P00410867OtherRAILROAD MEDICARE
SC248761Medicaid
P00410867OtherRAILROAD MEDICARE
SC248761Medicaid
GA93BFDCRMedicare PIN
TX1902855794OtherTRICARE SOUTH
TX8L22385Medicare PIN