Provider Demographics
NPI:1730704172
Name:WILLIAMS, BRET RICHARD (OD)
Entity type:Individual
Prefix:DR
First Name:BRET
Middle Name:RICHARD
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:24307 HARPER AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48080-1271
Mailing Address - Country:US
Mailing Address - Phone:586-775-6733
Mailing Address - Fax:586-775-0397
Practice Address - Street 1:1000 PINE GROVE AVE
Practice Address - Street 2:
Practice Address - City:PORT HURON
Practice Address - State:MI
Practice Address - Zip Code:48060-3733
Practice Address - Country:US
Practice Address - Phone:810-982-3200
Practice Address - Fax:810-982-4480
Is Sole Proprietor?:No
Enumeration Date:2020-06-11
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4901005435152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist