| Dr Michael C Williams, MD | |
|
1000 Mar Walt Dr, Fort Walton Beach, FL 32547-6708 | |
| (850) 863-7607 | |
| (205) 437-5998 |
| Full Name | Dr Michael C Williams |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Location | 1000 Mar Walt Dr, Fort Walton Beach, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023066776 | NPI | - | NPPES |
| 059190007 | Other | AL | BCBS PROVIDER NUMBER |
| 059189774 | Other | AL | BCBS PROVIDER NUMBER |
| 265505500 | Medicaid | FL | |
| 62835 | Other | FL | BCBS PROVIDER NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | ME85517 (Florida) | Primary |
| Entity Name | Emergency Medicine Services Of Fl Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1043917180 PECOS PAC ID: 8426413931 Enrollment ID: O20230504001881 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Michael C Williams, MD Po Box 88452, Chicago, IL 60680-1452 Ph: (205) 437-6098 | Dr Michael C Williams, MD 1000 Mar Walt Dr, Fort Walton Beach, FL 32547-6708 Ph: (850) 863-7607 |
Mrs. Andrea M Person, PA Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1000 Mar Walt Dr, Fort Walton Beach, FL 32547 Phone: 850-862-1111 | |
Dr. Paula S Wadbrook, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 1000 Mar Walt Dr, Fort Walton Beach, FL 32547 Phone: 850-863-7607 Fax: 205-437-5998 | |
Dr. Lon A Boutiette, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 1000 Mar Walt Dr, Fort Walton Beach, FL 32547 Phone: 850-863-7607 Fax: 205-437-5998 | |
Dr. William Mendoza, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 1000 Mar Walt Dr, Fort Walton Beach, FL 32547 Phone: 850-863-7607 Fax: 205-437-5998 | |
Dr. Jason H Adams, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1000 Mar Walt Dr, Fort Walton Beach, FL 32547 Phone: 850-863-7607 Fax: 205-437-5998 | |
Dr. Grady L Burleson, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 1000 Mar Walt Dr, Fort Walton Beach, FL 32547 Phone: 850-863-7607 |