Individual
BRANDON MICHAEL WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2710 S RIFE MEDICAL LN, ROGERS, AR 72758-1452
(479) 338-8000
(479) 338-3056
Mailing address
607 STAGECOACH VLG, LITTLE ROCK, AR 72210-4773
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R093973
AR
367500000X
Certified Registered Nurse Anesthetist
Primary
C003142
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1D7722
BCBS ARKANSAS
AR
05
—
214923001
—
AR
05
—
910084593
—
MO
Enumeration date
02/12/2016
Last updated
06/18/2021
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