Provider Demographics
NPI:1629044094
Name:WILLIAMS, ROBERT LAYTON (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:LAYTON
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 1:302 UNIVERSITY PKWY
Mailing Address - Street 2:AIKEN REGIONAL MEDICAL CENTERS PATHOLOGY DEPT.
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29801-6302
Mailing Address - Country:US
Mailing Address - Phone:803-641-5171
Mailing Address - Fax:803-641-5140
Practice Address - Street 1:302 UNIVERSITY PKWY
Practice Address - Street 2:AIKEN REGIONAL MEDICAL CENTERS PATHOLOGY DEPT.
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29801-6302
Practice Address - Country:US
Practice Address - Phone:803-641-5171
Practice Address - Fax:803-641-5140
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2015-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0078980207ZP0102X
SCTL30460207ZP0102X
SC30460207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC30460OtherSOUTH CAROLINA MEDICAL LICENSE PERMANENT
SCTL30460OtherSOUTH CAROLINA MEDICAL LICENSE TEMPORARY
SC304600Medicaid
SCTL30460OtherSOUTH CAROLINA MEDICAL LICENSE TEMPORARY
FL265787200Medicaid
SCTL30460OtherSOUTH CAROLINA MEDICAL LICENSE TEMPORARY
FLH07496Medicare UPIN