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Individual

DR. PAMELA SUE WILLIAMS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
98 POPLAR ST, BLACKFOOT, ID 83221-1758
(208) 785-4100
Mailing address
98 POPLAR ST, BLACKFOOT, ID 83221-1758
(208) 785-4100

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
O-0454
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010163103
REGENCE BLUE SHIELD
ID
01
000010167601
RBS LAMERE
ID
01
323925
ALTIUS
ID
05
807841700
ID
01
S6167
BLUE CROSS
ID
01
S6241
BCS LAMERE
ID
Enumeration date
05/16/2007
Last updated
07/25/2008
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