Provider Demographics
NPI:1104861137
Name:WILLIAMS, FREDERICK ADKINS JR (MD)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:ADKINS
Last Name:WILLIAMS
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:100 E LIBERTY ST STE 800
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1428
Mailing Address - Country:US
Mailing Address - Phone:502-587-6010
Mailing Address - Fax:502-587-1314
Practice Address - Street 1:6400 DUTCHMANS PKWY STE 345
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40205-3370
Practice Address - Country:US
Practice Address - Phone:502-587-6010
Practice Address - Fax:502-587-1314
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2019-08-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY22552207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64225527Medicaid
KY64225527Medicaid
KYC72292Medicare UPIN
KYK159110Medicare PIN