Individual
DR. ROGER MARK WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
501 DR MICHAEL DEBAKEY DR, LAKE CHARLES, LA 70601-5724
(337) 477-6172
(337) 477-1422
Mailing address
PO BOX 4388, LAKE CHARLES, LA 70606-4388
(337) 477-6172
(337) 477-1422
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
016891
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1366901
—
LA
01
—
76-0216590
TRICARE/CHAMPUS
LA
Enumeration date
08/18/2005
Last updated
07/21/2009
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