MEDICARE: DR. RICHARD ALLAN WILLIAMS MD

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	4993	NH

General Provider Information

NPI Number	:	1487646618
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD ALLAN WILLIAMS MD

Provider Business Mailing Address
First Line	:	1045 N VISTA VERDE
Second Line	:
City	:	LITCHFIELD PARK
State	:	AZ
Zip	:	85340-4501
Country	:	US
Telephone Number	:	623-856-4188
Fax Number	:

Provider Business Practice Location Address
First Line	:	7219 N LITCHFIELD RD
Second Line	:
City	:	LUKE AFB
State	:	AZ
Zip	:	85309-1529
Country	:	US
Telephone Number	:	623-856-3130
Fax Number	:

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

Provider Enumeration Date	:	08/15/2005
Last Update Date	:	07/08/2007

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