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General NPI Number Information
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NPI Number | 1538118245
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Entity Type | Organization
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Legal Business Name | ROGER TODD WILLIAMS MD PSC
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Dates
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Enumeration Date | 05/09/2006
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Last Update Date | 11/18/2008
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Provider Practice Location Address
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Address Line | 400 N DIXIE HWY
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City | CAVE CITY
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State | KY
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Zip | 42127-9512
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Country | US
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Telephone | 270-773-3737
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Fax | 270-773-3738
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Provider Business Mailing Address
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Address Line | 400 N DIXIE HWY
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City | CAVE CITY
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State | KY
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Zip | 42127-9512
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Country | US
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Telephone | 270-773-3737
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Fax | 270-773-3738
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Authorized Official
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Title or Position | OWNER/ PHYSICIAN
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Name | DR. ROGER TODD WILLIAMS
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Credential | M.D.
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Telephone | 270-773-3737
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 37488
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License Number State | KY
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