Provider Demographics
NPI:1558627125
Name:WILLIAMS, ROBERT ANDREW (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ANDREW
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:222 MEDICAL CIR
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD
Mailing Address - State:KY
Mailing Address - Zip Code:40351-1179
Mailing Address - Country:US
Mailing Address - Phone:606-783-6611
Mailing Address - Fax:
Practice Address - Street 1:3615 NEWBURG RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40218-3368
Practice Address - Country:US
Practice Address - Phone:502-909-0772
Practice Address - Fax:855-859-0123
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-07
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK29179207P00000X
KY48644207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK29179OtherOK MEDICAL LICENSE
KY48644OtherKY MED LICENSE
FLME130007OtherFL MED LICENSE
TXR1673OtherTX MED LICENSE