Provider Demographics
NPI:1437370947
Name:WILLIAMS, STEPHEN A (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:A
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2880 NW STEWART PKWY
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ROSEBURG
Mailing Address - State:OR
Mailing Address - Zip Code:97471-1202
Mailing Address - Country:US
Mailing Address - Phone:541-229-4070
Mailing Address - Fax:541-229-4074
Practice Address - Street 1:2880 NW STEWART PARKWAY
Practice Address - Street 2:SUITE 300
Practice Address - City:ROSEBURG
Practice Address - State:OR
Practice Address - Zip Code:97471-1201
Practice Address - Country:US
Practice Address - Phone:541-229-4070
Practice Address - Fax:541-229-4074
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ORMD27562207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR272439Medicaid
ORR138262Medicare UPIN