Provider Demographics
NPI:1821034596
Name:WILLIAMS, REX B (MD)
Entity Type:Individual
Prefix:
First Name:REX
Middle Name:B
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 1:1401 OVEN PARK DR
Mailing Address - Street 2:STE 201
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-7958
Mailing Address - Country:US
Mailing Address - Phone:850-765-8623
Mailing Address - Fax:
Practice Address - Street 1:120 STONE CREEK BLVD
Practice Address - Street 2:SUITE 500
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-8205
Practice Address - Country:US
Practice Address - Phone:601-420-2040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2020-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME92922207LP2900X
MS19128207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS302G708049OtherMEDICARE PTAN