Provider Demographics
NPI:1851339709
Name:WILLIAMS, ROBERT SIMPSON (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:SIMPSON
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 1:2525 W UNIVERSITY AVE
Mailing Address - Street 2:SUITE 504
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47303-3421
Mailing Address - Country:US
Mailing Address - Phone:765-289-7127
Mailing Address - Fax:765-289-8628
Practice Address - Street 1:2525 W UNIVERSITY AVE
Practice Address - Street 2:SUITE 504
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47303-3421
Practice Address - Country:US
Practice Address - Phone:765-289-7127
Practice Address - Fax:765-289-8628
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01037193208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000091191OtherBLUE CROSS
IN100106860AMedicaid
IN000000091191OtherBLUE CROSS
IN100106860AMedicaid