Healthcare Provider Details

I. General information

NPI: 1861509689
Provider Name (Legal Business Name): BENJAMIN A. WILLIAMS II M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2006
Last Update Date: 08/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11720 EDUCATION ST SUITE 224
AUBURN CA
95602-2419
US

IV. Provider business mailing address

PO BOX 255228
SACRAMENTO CA
95865-5228
US

V. Phone/Fax

Practice location:
  • Phone: 530-886-6820
  • Fax: 530-886-6821
Mailing address:
  • Phone: 855-771-0335
  • Fax: 916-503-3886

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberG530950
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberG53095
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: