Healthcare Provider Details

I. General information

NPI: 1154459196
Provider Name (Legal Business Name): WILLIAMS RADIOLOGY ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 MIDDLE ST WEEKS MEDICAL CENTER
LANCASTER NH
03584
US

IV. Provider business mailing address

PO BOX 35
LOWER WATERFORD VT
05848-0035
US

V. Phone/Fax

Practice location:
  • Phone: 603-788-4911
  • Fax: 603-788-5062
Mailing address:
  • Phone: 802-748-5415
  • Fax: 802-748-1768

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number27116
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number01017837A
License Number StateIN
# 3
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number6224
License Number StateNH

VIII. Authorized Official

Name: DR. RUSSELL STUART WILLIAMS
Title or Position: RADIOLOGIST
Credential: MD
Phone: 802-748-5415