Provider Demographics
NPI:1972559755
Name:WILLIAMS, O'RELL RONALD (MD)
Entity Type:Individual
Prefix:
First Name:O'RELL
Middle Name:RONALD
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 1:5000 W CHAMBERS ST
Mailing Address - Street 2:SUITE 2222
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53210-1650
Mailing Address - Country:US
Mailing Address - Phone:414-874-4316
Mailing Address - Fax:414-874-4160
Practice Address - Street 1:5000 W CHAMBERS ST
Practice Address - Street 2:SUITE 2222
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53210-1650
Practice Address - Country:US
Practice Address - Phone:414-874-4316
Practice Address - Fax:414-874-4160
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI45383207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
I15948Medicare UPIN