MEDICARE: DR. RONALD KENNETH WILLIAMS JR. D.O

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	OS-7492	FL

General Provider Information

NPI Number	:	1104894716
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RONALD KENNETH WILLIAMS JR. D.O

Provider Business Mailing Address
First Line	:	2415 WESTMONT DR
Second Line	:
City	:	ROYAL PALM BEACH
State	:	FL
Zip	:	33411-6139
Country	:	US
Telephone Number	:	561-791-9931
Fax Number	:

Provider Business Practice Location Address
First Line	:	7305 NORTH MILITARY TRAIL
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33410-6400
Country	:	US
Telephone Number	:	561-254-0515
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/09/2006
Last Update Date	:	09/05/2007

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