Provider Demographics
NPI:1417911009
Name:WILLIAMS, KENNETH V (DO)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:V
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:6101 LIMEKILN PIKE
Mailing Address - Street 2:MEDICAL SUITE
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19141-1423
Mailing Address - Country:US
Mailing Address - Phone:215-548-2010
Mailing Address - Fax:215-548-2130
Practice Address - Street 1:6101 LIMEKILN PIKE
Practice Address - Street 2:MEDICAL SUITE
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19141-1423
Practice Address - Country:US
Practice Address - Phone:215-548-2010
Practice Address - Fax:215-548-2130
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS-008437-L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine