Healthcare Provider Details

I. General information

NPI: 1598728727
Provider Name (Legal Business Name): PATRICK WILLIAMS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2006
Last Update Date: 03/07/2024
Certification Date: 03/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4359 NEW SHEPHERDSVILLE RD UNIT 100
BARDSTOWN KY
40004-8002
US

IV. Provider business mailing address

PO BOX 936
LONDON KY
40743-0936
US

V. Phone/Fax

Practice location:
  • Phone: 502-350-5700
  • Fax: 502-350-5701
Mailing address:
  • Phone: 606-330-7835
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number40909
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number40909
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: