MEDICARE: KENNETH WILLIAMS M.D., M.S.

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	208100000X	Physical Medicine & Rehabilitation Physician	14222R	LA

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

General Provider Information

NPI Number	:	1275525321
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENNETH WILLIAMS M.D., M.S.

Provider Business Mailing Address
First Line	:	3361 GEN DE GAULLE DR
Second Line	:	SUITE B
City	:	NEW ORLEANS
State	:	LA
Zip	:	70114-6701
Country	:	US
Telephone Number	:	504-367-5303
Fax Number	:	504-367-4071

Provider Business Practice Location Address
First Line	:	3361 GEN DE GAULLE DR
Second Line	:	SUITE B
City	:	NEW ORLEANS
State	:	LA
Zip	:	70114-6701
Country	:	US
Telephone Number	:	504-367-5303
Fax Number	:	504-367-4071

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

Provider Enumeration Date	:	08/16/2005
Last Update Date	:	07/14/2009

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