Provider Demographics
NPI:1528736709
Name:WILLIAMS, CARLY ELIZABETH
Entity type:Individual
Prefix:
First Name:CARLY
Middle Name:ELIZABETH
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CARLY
Other - Middle Name:ELIZABETH
Other - Last Name:EBINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:BAYNE JONES ARMY COMMUNITY HOSPITAL 1585 THIRD ST
Mailing Address - Street 2:
Mailing Address - City:FORT POLK
Mailing Address - State:LA
Mailing Address - Zip Code:71459-2025
Mailing Address - Country:US
Mailing Address - Phone:337-531-3011
Mailing Address - Fax:
Practice Address - Street 1:BAYNE-JONES ARMY COMMUNITY HOSPITAL
Practice Address - Street 2:1585 THIRD ST
Practice Address - City:FORT POLK
Practice Address - State:LA
Practice Address - Zip Code:71459
Practice Address - Country:US
Practice Address - Phone:501-239-3353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-01
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROT2021-020225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist