Provider Demographics
NPI:1992110993
Name:WILLIAMS, ARNOLD DEAN JR
Entity type:Individual
Prefix:MR
First Name:ARNOLD
Middle Name:DEAN
Last Name:WILLIAMS
Suffix:JR
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 1:18542 I 70 RD
Mailing Address - Street 2:
Mailing Address - City:RUSSELL
Mailing Address - State:KS
Mailing Address - Zip Code:67665-8856
Mailing Address - Country:US
Mailing Address - Phone:785-639-8001
Mailing Address - Fax:
Practice Address - Street 1:18542 I 70 RD
Practice Address - Street 2:
Practice Address - City:RUSSELL
Practice Address - State:KS
Practice Address - Zip Code:67665-8856
Practice Address - Country:US
Practice Address - Phone:785-639-8001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-27
Last Update Date:2014-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications