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General NPI Number Information
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NPI Number | 1225505571
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Entity Type | Organization
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Legal Business Name | WILLIAMSMD LLC
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Dates
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Enumeration Date | 10/25/2018
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Last Update Date | 08/02/2024
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Provider Practice Location Address
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Address Line | 1700 66TH ST N STE 302
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City | ST PETERSBURG
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State | FL
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Zip | 33710-5500
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Country | US
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Telephone | 727-547-0239
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Fax | 727-547-0523
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Provider Business Mailing Address
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Address Line | 6016 KIPPS COLONY DR E
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City | GULFPORT
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State | FL
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Zip | 33707-3967
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Country | US
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Telephone | 520-260-6046
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LUKE C WILLIAMS
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Credential | MD
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Telephone | 727-221-2297
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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