Provider Demographics
NPI:1548297880
Name:WILLIAMS-LEBER, ERIN L (P A)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:L
Last Name:WILLIAMS-LEBER
Suffix:
Gender:F
Credentials:P A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 MEADOW VIEW DR
Mailing Address - Street 2:
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-7521
Mailing Address - Country:US
Mailing Address - Phone:406-723-1300
Mailing Address - Fax:406-723-1310
Practice Address - Street 1:300 W MERCURY ST
Practice Address - Street 2:
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-1652
Practice Address - Country:US
Practice Address - Phone:406-723-1300
Practice Address - Fax:406-723-1335
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT319363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT4300517Medicaid
MT94383OtherBCBS
MT82773Medicare ID - Type UnspecifiedMEDICARE
MT94383OtherBCBS