Healthcare Provider Details

I. General information

NPI: 1881802999
Provider Name (Legal Business Name): GERALD ALAN WILLIAMS D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 08/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1719 E 19TH AVE ROCKY MOUNTAIN HOSPITAL FOR CHILRDEN PIC
DENVER CO
80218-1235
US

IV. Provider business mailing address

1719 E 19TH AVE ROCKY MOUNTAIN HOSPITAL FOR CHILREN- PICU 3C
DENVER CO
80218
US

V. Phone/Fax

Practice location:
  • Phone: 702-754-4300
  • Fax:
Mailing address:
  • Phone: 702-754-4300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberDR-50064
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number20A9713
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License NumberDR-50064
License Number StateCO
# 4
Primary TaxonomyN
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License Number20A9713
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: