Healthcare Provider Details

I. General information

NPI: 1629062690
Provider Name (Legal Business Name): GARY B WILLIAMS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2005
Last Update Date: 11/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 ARCH ST SUITE 405
AKRON OH
44304-1429
US

IV. Provider business mailing address

75 ARCH ST SUITE 405
AKRON OH
44304-1429
US

V. Phone/Fax

Practice location:
  • Phone: 330-253-5335
  • Fax: 330-253-6233
Mailing address:
  • Phone: 330-253-5335
  • Fax: 330-253-6233

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number35036436
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: