Provider Demographics
NPI:1235217639
Name:WILLIAMS, PATRICK MURRAY (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:MURRAY
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12801 WOODSIDE DR
Mailing Address - Street 2:
Mailing Address - City:PROSPECT
Mailing Address - State:KY
Mailing Address - Zip Code:40059-7125
Mailing Address - Country:US
Mailing Address - Phone:502-569-7983
Mailing Address - Fax:502-569-4989
Practice Address - Street 1:200 E CHESTNUT ST
Practice Address - Street 2:SVS BLDG SUITE 303
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1831
Practice Address - Country:US
Practice Address - Phone:502-629-5552
Practice Address - Fax:502-629-3132
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2012-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY34120207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000392109OtherLOUISVILLE ANTHEM BLUE CROSS AND BLUE SHIED
KYP00948787OtherRAILROAD MCR KY - NIS
KY000000711411OtherANTHEM - NIS
KY126363OtherSIHO - NIS
IN201052020Medicaid
KY64035272Medicaid
KYK003470OtherMEDICARE PTAN - NIS
KY000000711411OtherANTHEM - NIS
KY126363OtherSIHO - NIS