Provider Demographics
NPI:1922360882
Name:WILLIAMS, KATY FARBER (MD)
Entity Type:Individual
Prefix:
First Name:KATY
Middle Name:FARBER
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1501 UNION AVE
Mailing Address - Street 2:SUITE A & B
Mailing Address - City:MOBERLY
Mailing Address - State:MO
Mailing Address - Zip Code:65270-9469
Mailing Address - Country:US
Mailing Address - Phone:660-263-5556
Mailing Address - Fax:660-263-0054
Practice Address - Street 1:1501 UNION AVE
Practice Address - Street 2:SUITE A & B
Practice Address - City:MOBERLY
Practice Address - State:MO
Practice Address - Zip Code:65270-9469
Practice Address - Country:US
Practice Address - Phone:660-263-5556
Practice Address - Fax:660-263-0054
Is Sole Proprietor?:No
Enumeration Date:2012-06-15
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015021032207Q00000X
MO2012016528207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine