Provider Demographics
NPI:1639236011
Name:WILLIAMS, BRETT ALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:BRETT
Middle Name:ALAN
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 28TH STREET SOUTH
Mailing Address - Street 2:SUITE 8
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405
Mailing Address - Country:US
Mailing Address - Phone:406-761-6500
Mailing Address - Fax:406-452-5140
Practice Address - Street 1:1300 28TH STREET SOUTH
Practice Address - Street 2:SUITE 8
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405
Practice Address - Country:US
Practice Address - Phone:406-761-6500
Practice Address - Fax:406-452-5140
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT6726208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT87269Medicaid
MT84724Medicare ID - Type Unspecified
E60493Medicare UPIN