Provider Demographics
NPI:1508828005
Name:WILLIAMS, SCOTT G (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:G
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1551 WALL ST
Mailing Address - Street 2:SUITE310
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63303-3539
Mailing Address - Country:US
Mailing Address - Phone:636-669-2268
Mailing Address - Fax:636-669-2401
Practice Address - Street 1:1101 HIGHWAY K
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63366-8431
Practice Address - Country:US
Practice Address - Phone:636-978-2492
Practice Address - Fax:636-669-2401
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2012-08-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO107696207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO208026401Medicaid
MO208026401Medicaid