Healthcare Provider Details

I. General information

NPI: 1952398463
Provider Name (Legal Business Name): CAMERON SEYMOUR WILLIAMS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2005
Last Update Date: 08/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 N HOSPITAL DR
PRICE UT
84501-4218
US

IV. Provider business mailing address

PO BOX 1276
SALEM UT
84653-1276
US

V. Phone/Fax

Practice location:
  • Phone: 435-637-4864
  • Fax: 435-636-4896
Mailing address:
  • Phone: 801-423-3306
  • Fax: 801-423-3309

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number167155-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: