Williams, Charles Dale

Williams, Charles Dale is an sole proprietor health care provider with primary practice located at 96Mdg 307 Boatner Road, Ste 113, Eglin Afb FL 32542. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Allopathic & Osteopathic Physicians / Pain Medicine. Allopathic & Osteopathic Physicians / Anesthesiology is his primary health care specialty. Williams, Charles Dale can be contacted via phone (850) 883-9957.

Contact Information

Primary practice address
96Mdg 307 Boatner Road, Ste 113 Eglin Afb FL 32542
Phone: (850) 883-9957
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X A100136 California
Allopathic & Osteopathic Physicians / Pain Medicine 207LP2900X MD451007 Pennsylvania

Profile Details

NPI number 1083804421
LBN Legal business name Williams, Charles Dale
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 1st, 2007
Last updated Oct 17th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1083804421 NPPES
Pennsylvania MEDICAID 356346

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