Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | DSO3O800R | PA |
Y | 213EG0000X | General Practice | DSO3O800R | PA |
NPI | 1003919077 |
---|---|
Provider Name | Dr. Delisa T Williams |
First Address | Lancaster, PA 17601-5762 |
Second Address | East Earl, PA 17519-0100 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/09/2006 |
Last Update Date | 08/07/2007 |