Provider Demographics
NPI:1619028404
Name:WILLIAMS, ROBERT DAVIS (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:DAVIS
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 1:1597 HARRINGTON PARK DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32225-4919
Mailing Address - Country:US
Mailing Address - Phone:304-633-5595
Mailing Address - Fax:
Practice Address - Street 1:1597 HARRINGTON PARK DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32225-4919
Practice Address - Country:US
Practice Address - Phone:304-633-5595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2010-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME305182207P00000X
ALMD29580207P00000X
GA062795207P00000X
LAMD203401207P00000X
MS20885207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine