MEDICARE: WILLIAMS FAMILY MEDICINE PC

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	16482	NE

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	092156	OTHER	NE	MEDICARE ID TYPE UNSPECIFIED

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	88009	OTHER	NE	COVENTRY
4	01-00109	OTHER	NE	UNITED HEALTH CARE

General Provider Information

NPI Number	:	1194943290
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WILLIAMS FAMILY MEDICINE PC

Provider Business Mailing Address
First Line	:	9015 ARBOR ST
Second Line	:	SUITE 106
City	:	OMAHA
State	:	NE
Zip	:	68124-2056
Country	:	US
Telephone Number	:	402-391-6623
Fax Number	:	402-391-6983

Provider Business Practice Location Address
First Line	:	9015 ARBOR ST
Second Line	:	SUITE 106
City	:	OMAHA
State	:	NE
Zip	:	68124-2056
Country	:	US
Telephone Number	:	402-391-6623
Fax Number	:	402-391-6983

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. STEPHEN H WILLIAMS
Credential	:	MD
Telephone Number	:	402-391-6623

Provider Enumeration Date	:	04/23/2007
Last Update Date	:	01/11/2013

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Directions to “WILLIAMS FAMILY MEDICINE PC ” Practice Location

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