Healthcare Provider Details

I. General information

NPI: 1871603936
Provider Name (Legal Business Name): GUY WILLIAMS DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

939 S 106TH PLZ SUITE 101
OMAHA NE
68114-4782
US

IV. Provider business mailing address

5200 DODGE ST ANESTHESIA DEPARTMENT
OMAHA NE
68114-4113
US

V. Phone/Fax

Practice location:
  • Phone: 402-955-7986
  • Fax:
Mailing address:
  • Phone: 402-955-7986
  • Fax: 402-955-4300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number35079
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: