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General NPI Number Information
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NPI Number | 1568514701
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Entity Type | Individual
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Provider Name | ROBERT ALLEN WILLIAMS D.O.
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Gender | Male
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 04/30/2021
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Provider Practice Location Address
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Address Line | 117 W BAY ST
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City | WAUCHULA
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State | FL
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Zip | 33873-3135
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Country | US
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Telephone | 863-773-4700
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Fax | 863-773-2916
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Provider Business Mailing Address
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Address Line | 461 E TEN MILE RD
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City | PENSACOLA
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State | FL
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Zip | 32534-9712
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Country | US
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Telephone | 863-773-4700
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Fax | 863-773-2916
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS13940
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License Number State | FL
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