Provider Demographics
NPI:1013939289
Name:WILLIAMS, ROBERT GEORGE (RPH, BS)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:GEORGE
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:RPH, BS
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 217
Mailing Address - Street 2:
Mailing Address - City:MC ALLISTER
Mailing Address - State:MT
Mailing Address - Zip Code:59740-0217
Mailing Address - Country:US
Mailing Address - Phone:406-682-4109
Mailing Address - Fax:406-682-4109
Practice Address - Street 1:7 GREY HACKLE LANE
Practice Address - Street 2:
Practice Address - City:MCALLISTER
Practice Address - State:MT
Practice Address - Zip Code:59740-0217
Practice Address - Country:US
Practice Address - Phone:406-682-4109
Practice Address - Fax:406-682-4109
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT3538183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist