Provider Demographics
NPI:1861509689
Name:WILLIAMS, BENJAMIN A II (MD)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:A
Last Name:WILLIAMS
Suffix:II
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:PO BOX 255228
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95865-5228
Mailing Address - Country:US
Mailing Address - Phone:855-771-0335
Mailing Address - Fax:916-503-3886
Practice Address - Street 1:11720 EDUCATION ST
Practice Address - Street 2:SUITE 224
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95602-2419
Practice Address - Country:US
Practice Address - Phone:530-886-6820
Practice Address - Fax:530-886-6821
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG530950174400000X
CAG53095207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF19570Medicare UPIN
CAG530950Medicare ID - Type Unspecified