WALTER LEROY WILLIAMS (NPI# 1841269248) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841269248 |
| Entity Type | Individual |
| Full Name | WALTER LEROY WILLIAMS |
| Credential | M.D. |
| Practice Address |
1433 5th St. Clarkston WA 99403-2714 |
| Practice Telephone | 5097585141 |
| Practice Fax Number | 5097585299 |
| Mailing Telephone | 5097585141 |
| Mailing Fax Number | 5097585299 |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2019-12-30 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | MD00041565 | WA | Other Service Providers |
| Y | 207N00000X | Dermatology | MD00041565 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | PREMERA BLUE CROSS # | 030734610 | 01 |
| ID | 806377300 | 05 | |
| WA | RAILROAD MEDICARE # | P00007739 | 01 |
| ID | BLUE CROSS OF IDAHO | 72157 | 01 |
| WA | DEA# | BW6762834 | 01 |
| WA | WASHINGTON LICENSE | MD00041565 | 01 |
| ID | REGENCE BLUE SHIELD PROV. | 000010139009 | 01 |
| WA | WASHINGTON MEDICAID # | 1117878 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003446436 | Walter Gerrard Williams II | Nurse Anesthetist, Certified Registered | 32480 W Nimrod St, Solon, OH 44139-4436 | 2020-01-24 |
| 1326608928 | Walter Cornelius Williams Jr. | Physical Therapy Assistant | 3536 Lena Ln, Greenville, NC 27834-6163 | 2019-06-17 |
| 1083137525 | Walter Wendell Williams | Internal Medicine | 6051 Rock Springs Rd, Lithonia, GA 30038-1508 | 2017-07-17 |
| 1881853174 | Walter Keith Williams Jr. | Counselor | 3940 Holly Hill Rd, Lake Charles, LA 70605-2531 | 2008-06-03 |
| 1316935737 | Walter Herbert Williams | Dentist | Uss Batan, Dental Dept, Fpo, AE 09554-1657 | 2005-10-10 |
| 1598387086 | Walter Williams | Counselor | 128 E Olin Ave Ste 100, Madison, WI 53713-1467 | 2020-05-07 |
| 1497247134 | Walter Williams | Community Health Worker | 3500 Carnegie Ave, Cleveland, OH 44115-2641 | 2018-05-30 |
| 1629500327 | Walter Williams | Community Health Worker | 212 Ashbury St, San Francisco, CA 94117-2025 | 2017-03-31 |
| 1063810398 | Walter Lee Williams | Counselor | 770 Woodlane Rd, Westampton, NJ 08060-3804 | 2014-12-19 |
| 1831439777 | Walter Thomas Williams | Pharmacist | 405 S Hill St, Griffin, GA 30224-4225 | 2013-02-28 |
| Street Address |
1433 5TH ST. |
| City | CLARKSTON |
| State | WA |
| Zip Code | 99403-2714 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306409669 | Jessica Elaine Krull | Specialist/Technologist | 807 3rd Street, Clarkston, WA 99403 | 2019-04-22 |
| 1477006526 | Idaho County Rideshare | Non-emergency Medical Transport (VAN) | 1470 Elm Street, Clarkston, WA 99403 | 2016-07-25 |
| 1679921340 | Jonathan Preszler | Counselor | 629 6th Street, Educational and Psychological Services, Clarkston, WA 99403 | 2016-06-02 |
| 1104204957 | Optimal Health and Wellness | Clinic/Center | 1267 Belmont Way, Clarkston, WA 99403 | 2015-05-13 |
| 1326456351 | David Nygren | Pharmacist | 506 5th St, Clarkston, WA 99403 | 2014-07-22 |
| 1255672895 | Alpowa Healthcare, Inc. | Hospice Care, Community Based | 1370 Bridge Street, Clarkston, WA 99403 | 2013-03-06 |
| 1265799407 | Elizabeth Bagnulo Dacey | Pathology | 1225 Highland Avenue, Clarkston, WA 99403 | 2012-04-12 |
| 1649586256 | Zeeshan Afzal | Internal Medicine | 1119 Highland Ave Ste 3, Clarkston, WA 99403 | 2010-08-20 |
| 1154657955 | Twin River Vision, Inc. | Optometrist | 306 5th Street, Clarkston, WA 99403 | 2009-10-29 |
| 1649429317 | Elizabeth Marie Allen-racicot | Specialist | 1013 Bridge Street, Clarkston, WA 99403 | 2008-09-17 |
| Find all providers in zip 99403 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518175116 | Jennifer Trepte Caudill | Dermatology | 5885 S. Main St., Suite 1, Clarkston, MI 48346 | 2007-05-18 |
| 1285752998 | Brett Barry Bender | Dermatology | 5701 Bow Pointe Dr Ste 215, Clarkston, MI 48346-5400 | 2007-03-27 |
| 1093700247 | Susan Hanson Klemmer | Dermatology | 6080 Dixie Hwy, Suite B, Clarkston, MI 48346-3493 | 2005-09-14 |
| 1780027961 | Michelle Dawson | Dermatology | 5701 Bow Pointe Dr Ste 215, Clarkston, MI 48346-5400 | 2013-04-08 |
| 1477841245 | Jennifer Caudill, Md Pllc | Dermatology | 6080 Dixie Hwy, Suite B, Clarkston, MI 48346-3493 | 2011-07-14 |
| 1083916407 | Susan H Klemmer Md PC | Dermatology | 6080 Dixie Hwy, Suite B, Clarkston, MI 48346-3493 | 2010-11-18 |
| 1093977985 | Brian A Kopitzki | Dermatology | 5701 Bow Pointe Dr Ste 215, Clarkston, MI 48346-5400 | 2008-07-01 |
| 1053512111 | Richard S Schwartz M D Dermatology P C | Dermatology | 6770 Dixie Hwy, Suite 304, Clarkston, MI 48346-2087 | 2007-05-29 |
| 1003943408 | Clarkston Dermatology & Vein Center Pllc | Dermatology | 5701 Bow Pointe Dr, Suite 215, Clarkston, MI 48346-3198 | 2007-02-27 |
| 1528152196 | Wendy L Mcfalda | Dermatology | 5701 Bow Pointe Dr, Suite 215, Clarkston, MI 48346-3198 | 2006-10-03 |
| Find all providers in CLARKSTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.