MEDICARE: KYRA C WILLIAMS MD

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	207V00000X	Obstetrics & Gynecology Physician	25MA08088700	NJ
2	207VX0000X	Obstetrics Physician	MD448247	PA

General Provider Information

NPI Number	:	1124090485
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KYRA C WILLIAMS MD

Provider Business Mailing Address
First Line	:	3701 MARKET STREET
Second Line	:	3RD FLOOR
City	:	PHILADELPHIA
State	:	PA
Zip	:	19104
Country	:	US
Telephone Number	:	215-662-6035
Fax Number	:

Provider Business Practice Location Address
First Line	:	3701 MARKET STREET
Second Line	:	3RD FLOOR
City	:	PHILADELPHIA
State	:	PA
Zip	:	19104
Country	:	US
Telephone Number	:	215-662-6035
Fax Number	:

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

Provider Enumeration Date	:	02/02/2006
Last Update Date	:	06/28/2013

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