Healthcare Provider Details

I. General information

NPI: 1932194966
Provider Name (Legal Business Name): THOMAS A. WILLIAMS JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2005
Last Update Date: 11/05/2024
Certification Date: 11/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1532 LONE OAK RD STE 415
PADUCAH KY
42003-7943
US

IV. Provider business mailing address

2200 JEFFERSON AVE FL 5
TOLEDO OH
43604-7102
US

V. Phone/Fax

Practice location:
  • Phone: 270-442-0103
  • Fax: 270-442-0109
Mailing address:
  • Phone: 419-251-2032
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number235006-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number35503
License Number StateTN
# 3
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number56987
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: