Provider Demographics
NPI:1952304891
Name:WILLIAMS, PATRICIA M (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:M
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:PATRICIA
Other - Middle Name:S
Other - Last Name:ELLIOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1029 MEDICAL CENTER CIR STE 202
Mailing Address - Street 2:
Mailing Address - City:MAYFIELD
Mailing Address - State:KY
Mailing Address - Zip Code:42066-1189
Mailing Address - Country:US
Mailing Address - Phone:270-247-7795
Mailing Address - Fax:270-251-4551
Practice Address - Street 1:1029 MEDICAL CENTER CIR STE 202
Practice Address - Street 2:
Practice Address - City:MAYFIELD
Practice Address - State:KY
Practice Address - Zip Code:42066-1189
Practice Address - Country:US
Practice Address - Phone:270-247-7795
Practice Address - Fax:800-574-6540
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-24
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY24794207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64247943Medicaid
KYK348400OtherMEDICARE
KYP00719450OtherRAILROAD MEDICARE
KY1974701Medicare PIN