Provider Demographics
NPI:1740712108
Name:WILLIAMS, COLT (MD)
Entity type:Individual
Prefix:
First Name:COLT
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5423 RENO CORPORATE DR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-2250
Mailing Address - Country:US
Mailing Address - Phone:775-329-0222
Mailing Address - Fax:775-329-3010
Practice Address - Street 1:5423 RENO CORPORATE DR
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-2250
Practice Address - Country:US
Practice Address - Phone:775-329-0222
Practice Address - Fax:775-329-3010
Is Sole Proprietor?:No
Enumeration Date:2017-04-03
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN67054207RH0003X
NV23037207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology