| Williams Personalized Care LLC | |
|
2525 South St Ste A Lafayette IN 47904-3028 | |
| (765) 807-2320 | |
| (765) 807-2330 |
| Full Name | Williams Personalized Care LLC |
|---|---|
| Speciality | Family Medicine |
| Location | 2525 South St Ste A, Lafayette, Indiana |
| Authorized Official Name and Position | Mark Henry Williams (PHYSICIAN/OWNER) |
| Authorized Official Contact | 7658072320 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Williams Personalized Care LLC 3200 South St Unit 3 Lafayette IN 47904-3185 Ph: (765) 366-5776 | Williams Personalized Care LLC 2525 South St Ste A Lafayette IN 47904-3028 Ph: (765) 807-2320 |
| NPI Number | 1417766742 |
|---|---|
| Provider Enumeration Date | 01/02/2025 |
| Last Update Date | 01/02/2025 |
| Certification Date | 01/02/2025 |
| Medicare PECOS PAC ID | 2860917366 |
|---|---|
| Medicare Enrollment ID | O20250417000341 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417766742 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| Provider Name | Mark H Williams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700859873 PECOS PAC ID: 9133217318 Enrollment ID: I20071126000204 |
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