Mark M. Williams, M.D., P.a.

Primary specialty

SpecialistTaxonomy code 174400000X

License

ME0057987 Issued in FL

Legal business name

MARK M. WILLIAMS, M.D., P.A.

Practice address

2202 Country Club Dr
Lynn Haven, FL 32444-1992

Phone

(850) 381-1010

Fax

(888) 374-8684

NPI assigned

Sep 21, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Mark M Williams, MD

Title

President

Phone

(850) 769-2757

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Rachael Burnetsky, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Panama City, FL
  • NPI 1245471002
  NPD (past)
• Kristen Bryan Floyd, ARNP

  • Nurse Practitioner
  • Panama City, FL
  • NPI 1295805398
  NPD (past)
• Glenn Joseph Lysack, PA

  • Physician Assistant
  • Bremerton, WA
  • NPI 1578501094
  NPD (past)

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

{
    "created_epoch": "1190332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772064000000",
    "number": "1457547523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21C ORINDA WAY # 367",
            "city": "ORINDA",
            "state": "CA",
            "postal_code": "945632534",
            "telephone_number": "850-769-2757",
            "fax_number": "888-374-8684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2202 COUNTRY CLUB DR",
            "city": "LYNN HAVEN",
            "state": "FL",
            "postal_code": "324441992",
            "telephone_number": "850-381-1010",
            "fax_number": "888-374-8684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK M. WILLIAMS, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-21",
        "last_updated": "2026-02-26",
        "certification_date": "2026-02-26",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "850-769-2757",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME0057987",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "372895100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Carl E Mantecon Sr., RPH
• Marcia Pell Cde RDN LDN LLC
• Maria U Tedtaotao MD PA
• Jeannie Guerelle Marquis, LMT
• Tia Tajuana Martin
• Irina Mayberry, APRN
• MDL Health, PLLC
• Medstop PL LLC

• All providers in Lynn Haven, FL
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2026; 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.