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NPI Code Detail

MEDICARE: BENJAMEN HOWARD WILLIAMS M.D.

MEDICARE: BENJAMEN HOWARD WILLIAMS M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program125055317IL
2207Q00000XFamily Medicine Physician04-32164KS
3207Q00000XFamily Medicine Physician35959OK
42083A0100XAerospace Medicine Physician04-32164KS
5208D00000XGeneral Practice Physician04-32164KS

General Provider Information

NPI Number : 1255416558
Entity Type Code : Individual
Provider Name (Legal Business Name) : BENJAMEN HOWARD WILLIAMS M.D.
Provider Business Mailing Address
First Line : 3011 N MICHIGAN ST
Second Line :
City : PITTSBURG
State : KS
Zip : 66762-2546
Country : US
Telephone Number : 620-231-9873
Fax Number :
Provider Business Practice Location Address
First Line : 101 W SYCAMORE ST
Second Line :
City : COLUMBUS
State : KS
Zip : 66725-1276
Country : US
Telephone Number : 620-429-2101
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2006
Last Update Date : 08/20/2020

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