Provider Demographics
NPI:1669574620
Name:WILIAMS, WILBUR LEE (MD)
Entity type:Individual
Prefix:DR
First Name:WILBUR
Middle Name:LEE
Last Name:WILIAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:328 MONTCLAIRE DR NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87108-1126
Mailing Address - Country:US
Mailing Address - Phone:505-255-1419
Mailing Address - Fax:
Practice Address - Street 1:328 MONTCLAIRE DR NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87108-1126
Practice Address - Country:US
Practice Address - Phone:505-379-3474
Practice Address - Fax:505-255-6997
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NM72-253208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice