Healthcare Provider Details

I. General information

NPI: 1942534565
Provider Name (Legal Business Name): ALEXANDER WILLIAMS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2009
Last Update Date: 09/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 E ROOSEVELT ST
PHOENIX AZ
85008-4973
US

IV. Provider business mailing address

7004 S 21ST DR
PHOENIX AZ
85041-6567
US

V. Phone/Fax

Practice location:
  • Phone: 602-344-5808
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberR71493
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: