Individual
DR. MARK P WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
4067 E COURT ST, #10-11, BURTON, MI 48509-2509
(810) 715-2020
(810) 715-2021
Mailing address
4067 E COURT ST # 10-11, BURTON, MI 48509-2509
(810) 715-2020
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
4901002607
MI
152WL0500X
Low Vision Rehabilitation Optometrist
Primary
4901002607
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202115
MCLAREN PROVIDER NUMBER
MI
01
—
382219845
ALL OTHER INS
MI
01
—
900B56586
BCBS PROVIDER NUMBER
MI
05
—
945104868
—
MI
Enumeration date
01/06/2007
Last updated
07/08/2021
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