Individual
IDA C WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2124 14TH ST, MERIDIAN, MS 39301-4040
(601) 553-6000
(601) 553-6115
Mailing address
3711 A PL, MERIDIAN, MS 39301-1316
(601) 482-0092
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R098780
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00110075
—
MS
01
—
730-03794
BLUE CROSS OF AL
AL
Enumeration date
08/21/2006
Last updated
07/08/2007
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