MEDICARE: DR BRAD WILLIAMS 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	207X00000X	Orthopaedic Surgery Physician
2	207XX0005X	Sports Medicine (Orthopaedic Surgery) Physician	35254	AZ
3	207X00000X	Orthopaedic Surgery Physician	35254	AZ

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	:	1437187820
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR BRAD WILLIAMS PC

Provider Business Mailing Address
First Line	:	PO BOX 310
Second Line	:
City	:	COTTONWOOD
State	:	AZ
Zip	:	86326-6744
Country	:	US
Telephone Number	:	928-634-0323
Fax Number	:	928-634-1144

Provider Business Practice Location Address
First Line	:	299 S WILLARD STREET
Second Line	:
City	:	COTTONWOOD
State	:	AZ
Zip	:	86326-6744
Country	:	US
Telephone Number	:	928-634-0323
Fax Number	:	928-634-1144

Authorized Official
Title or Position	:	OWNER
Name	:	BRAD D WILLIAMS
Credential	:	MD
Telephone Number	:	928-634-1112

Provider Enumeration Date	:	06/28/2006
Last Update Date	:	12/07/2009

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Directions to “DR BRAD WILLIAMS PC ” Practice Location

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