Evan T Williams, O.D.
Individual provider Active NPI Optometrist · Leadington, MO
NPI 1124020672 · NPPES record last updated Jul 13, 2026
Key facts
- NPI
- 1124020672
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- TO2277 (MO)
- Practice address
- 200 E Woodlawn Dr
Leadington, MO 63601-4436 - Phone
- (573) 431-1301
- Fax
- (573) 431-9339
- NPI assigned
- Aug 15, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TO2277 | MO | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mark D Peckham OD PC | Optometrist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | TO2277 | MO | Yes |
Addresses
Primary practice location
200 E Woodlawn Dr
Leadington, MO 63601-4436
Mailing address
200 E Woodlawn Dr
Leadington, MO 63601-4436
Phone (573) 431-1301
Other providers in Leadington, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.