MEDICARE: R. BRIAN WILLIAMS, DO, PA

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	207X00000X	Orthopaedic Surgery Physician	161936700	FL

General Provider Information

NPI Number	:	1245745744
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	R. BRIAN WILLIAMS, DO, PA

Provider Business Mailing Address
First Line	:	3006 SHIPWATCH DR
Second Line	:
City	:	HOLIDAY
State	:	FL
Zip	:	34691-9601
Country	:	US
Telephone Number	:	727-919-0219
Fax Number	:

Provider Business Practice Location Address
First Line	:	2985 POST ROCK CT
Second Line	:
City	:	TARPON SPRINGS
State	:	FL
Zip	:	34688-7315
Country	:	US
Telephone Number	:	727-919-0219
Fax Number	:

Authorized Official
Title or Position	:	PHYSICIAN/OWNER
Name	:	R BRIAN WILLIAMS
Credential	:	DO
Telephone Number	:	727-919-0219

Provider Enumeration Date	:	12/06/2017
Last Update Date	:	08/09/2023

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