Provider Demographics
NPI:1245400951
Name:WILLIAMS, ROBERT A JR (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:A
Last Name:WILLIAMS
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:10900 W 44TH AVE
Mailing Address - Street 2:UNIT 100
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-2761
Mailing Address - Country:US
Mailing Address - Phone:720-923-1250
Mailing Address - Fax:303-284-4082
Practice Address - Street 1:3291 LOMA VISTA RD
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-3099
Practice Address - Country:US
Practice Address - Phone:805-652-6656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-10
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA99934207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
A99934OtherSTATE MEDICAL LICENSE