Dr Mark P Williams PC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

DR MARK P WILLIAMS PC

Practice address

4067 E Court St # 10-11
Burton, MI 48509-2509

Phone

(810) 715-2020

NPI assigned

Aug 4, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Mark P Williams, O.D.

Title

Owner/Doctor

Phone

(810) 715-2020

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1217808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409011200000",
    "number": "1184880668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4067 E COURT ST # 10-11",
            "city": "BURTON",
            "state": "MI",
            "postal_code": "485092509",
            "telephone_number": "810-715-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4067 E COURT ST # 10-11",
            "city": "BURTON",
            "state": "MI",
            "postal_code": "485092509",
            "telephone_number": "810-715-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR MARK P WILLIAMS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-04",
        "last_updated": "2014-08-26",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER/DOCTOR",
        "authorized_official_telephone_number": "810-715-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCLAREN HEALTH PLAN",
            "identifier": "202115",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5104868",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD OF MICHIGAN",
            "identifier": "OB56586",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Burton, MI
• Providers in Burton, MI by specialty
• Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.