Provider Demographics
NPI:1700249042
Name:WILLIAMS, JUSTIN KYLE (MD)
Entity Type:Individual
Prefix:
First Name:JUSTIN
Middle Name:KYLE
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 1:580 S AIKEN AVE STE 530
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15232-1531
Mailing Address - Country:US
Mailing Address - Phone:412-687-2100
Mailing Address - Fax:412-687-5883
Practice Address - Street 1:580 S AIKEN AVE STE 530
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15232-1531
Practice Address - Country:US
Practice Address - Phone:412-687-2100
Practice Address - Fax:412-687-5883
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-04
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA835532086S0122X, 2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery