Provider Demographics
NPI:1689136608
Name:WILLIAMS, MATTHEW WARREN (MD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:WARREN
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 S COLLEGE RD STE 304
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-3038
Mailing Address - Country:US
Mailing Address - Phone:337-232-2710
Mailing Address - Fax:337-232-6824
Practice Address - Street 1:1101 S COLLEGE RD STE 304
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-3038
Practice Address - Country:US
Practice Address - Phone:337-232-2710
Practice Address - Fax:337-232-6824
Is Sole Proprietor?:No
Enumeration Date:2019-04-01
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA335525207W00000X, 207WX0107X, 207WX0107X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2495879Medicaid