Provider Demographics
NPI:1801005699
Name:WILLIAMS, MARLON S (DC)
Entity type:Individual
Prefix:MR
First Name:MARLON
Middle Name:S
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BOX 10556
Mailing Address - Street 2:RR1 THE VILLAGE MALL BAY 12
Mailing Address - City:KINGSHILL ST CROIX
Mailing Address - State:VI
Mailing Address - Zip Code:00850-9604
Mailing Address - Country:US
Mailing Address - Phone:340-773-4300
Mailing Address - Fax:340-773-4300
Practice Address - Street 1:BAY 12 RR1
Practice Address - Street 2:THE VILLAGE MALL
Practice Address - City:KINGSHILL
Practice Address - State:VI
Practice Address - Zip Code:00850-9604
Practice Address - Country:US
Practice Address - Phone:340-773-4300
Practice Address - Fax:340-773-4300
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI9C111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor