Healthcare Provider Details

I. General information

NPI: 1922426782
Provider Name (Legal Business Name): S.TYLER WILLIAMS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: STEPHEN TYLER WILLIAMS

II. Dates (important events)

Enumeration Date: 03/30/2014
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4403 HARRISON BLVD STE 3650
OGDEN UT
84403-3288
US

IV. Provider business mailing address

PO BOX 27128
SALT LAKE CITY UT
84127-0128
US

V. Phone/Fax

Practice location:
  • Phone: 801-387-7125
  • Fax:
Mailing address:
  • Phone: 801-387-7125
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number7667285-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: