1275541179 NPI number — STANLEY J WILLIAMS MD PA

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275541179 NPI number — STANLEY J WILLIAMS MD PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
STANLEY J WILLIAMS MD PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1275541179
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/24/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1149
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
INVERNESS
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34451
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
352-860-0202
Provider Business Mailing Address Fax Number:
352-860-1918

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
511 W HIGHLAND BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
INVERNESS
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34452
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
352-860-0202
Provider Business Practice Location Address Fax Number:
352-860-1918
Provider Enumeration Date:
08/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
WILLIAMS
Authorized Official First Name:
STANLEY
Authorized Official Middle Name:
JOHN
Authorized Official Title or Position:
CARDIOLOGIST
Authorized Official Telephone Number:
352-860-0202

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X , with the licence number:  ME65864 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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