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NPI Code Detail

MEDICARE: BENJAMIN J. WILLIAMS MD, PHD, PA

MEDICARE: BENJAMIN J. WILLIAMS MD, PHD, 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
12084N0400XNeurology Physician

General Provider Information

NPI Number : 1528259900
Entity Type Code : Organization
Provider Name (Legal Business Name) : BENJAMIN J. WILLIAMS MD, PHD, PA
Provider Business Mailing Address
First Line : 4642 N LOOP 289 STE 203
Second Line :
City : LUBBOCK
State : TX
Zip : 79416-2424
Country : US
Telephone Number : 806-722-3030
Fax Number : 806-722-3035
Provider Business Practice Location Address
First Line : 4642 N LOOP 289 STE 203
Second Line :
City : LUBBOCK
State : TX
Zip : 79416-2424
Country : US
Telephone Number : 806-722-3030
Fax Number : 806-722-3035
Authorized Official
Title or Position : DOCTOR
Name : DR. BENJAMIN J WILLIAMS
Credential : MD, PHD, PA
Telephone Number : 806-722-3030
Provider Enumeration Date : 08/09/2007
Last Update Date : 08/09/2007

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