Williams, Douglas Stanley

Williams, Douglas Stanley is an individual health care provider with primary practice located at 9 Airport Rd , Blackfoot ID 83221-1702. He recently has 2 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, Podiatric Medicine & Surgery Service Providers / Podiatrist. Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery is his primary health care specialty. Williams, Douglas Stanley can be contacted via phone (208) 785-6700.

Contact Information

Primary practice address
9 Airport Rd Blackfoot ID 83221-1702
Phone: (208) 785-6700
Fax: (208) 785-6767
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X PD176R Louisiana
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X P-156 Idaho
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X P-156 Idaho

Profile Details

NPI number 1932106713
LBN Legal business name Williams, Douglas Stanley
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 7th, 2005
Last updated Aug 5th, 2021 - about 3 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 1932106713 NPPES
Idaho MEDICAID 804309300
Idaho Other P1571
Idaho Other 341488
Idaho Other 480034721
Idaho Other 000010015672
Idaho Other 461973001

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