Provider Demographics
NPI:1033485511
Name:WILLIAMS, SIGRID GARDNER (MD)
Entity Type:Individual
Prefix:
First Name:SIGRID
Middle Name:GARDNER
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 W ARBOR DR # MC8433
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-1911
Mailing Address - Country:US
Mailing Address - Phone:928-925-5088
Mailing Address - Fax:
Practice Address - Street 1:4751 N 15TH ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-3707
Practice Address - Country:US
Practice Address - Phone:602-263-2220
Practice Address - Fax:602-916-0600
Is Sole Proprietor?:No
Enumeration Date:2012-03-28
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA128995207V00000X
AZ57253207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ462098Medicaid
AZ57253OtherAZ MEDICAL BOARD