Healthcare Provider Details

I. General information

NPI: 1669420733
Provider Name (Legal Business Name): MARTIN KEITH WILLIAMS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

521 N BRIGHTLEAF BLVD
SMITHFIELD NC
27577-4407
US

IV. Provider business mailing address

521 N BRIGHTLEAF BLVD
SMITHFIELD NC
27577-4407
US

V. Phone/Fax

Practice location:
  • Phone: 252-399-2112
  • Fax: 252-399-2132
Mailing address:
  • Phone: 919-989-5500
  • Fax: 833-438-7008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number39715
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: