MEDICARE: DR. DONALD L WILLIAMS M.D.

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	207R00000X	Internal Medicine Physician	23304	WI

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	:	1326043266
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DONALD L WILLIAMS M.D.

Provider Business Mailing Address
First Line	:	1461 W MAIN ST STE B
Second Line	:
City	:	WHITEWATER
State	:	WI
Zip	:	53190-1568
Country	:	US
Telephone Number	:	262-472-6839
Fax Number	:	262-472-6802

Provider Business Practice Location Address
First Line	:	1461 W MAIN ST STE B
Second Line	:
City	:	WHITEWATER
State	:	WI
Zip	:	53190-1568
Country	:	US
Telephone Number	:	262-472-6839
Fax Number	:	262-472-6839

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

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	05/28/2024

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