Provider Demographics
NPI:1881082139
Name:PATRICKWILLIAMSMD,PLLC
Entity type:Organization
Organization Name:PATRICKWILLIAMSMD,PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:NORMAN
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-601-9394
Mailing Address - Street 1:1137 COUNTY ROAD 494
Mailing Address - Street 2:
Mailing Address - City:GRAND LAKE
Mailing Address - State:CO
Mailing Address - Zip Code:80447
Mailing Address - Country:US
Mailing Address - Phone:303-601-9394
Mailing Address - Fax:303-284-7668
Practice Address - Street 1:1137 COUNTY ROAD 494
Practice Address - Street 2:
Practice Address - City:GRAND LAKE
Practice Address - State:CO
Practice Address - Zip Code:80447
Practice Address - Country:US
Practice Address - Phone:303-601-9394
Practice Address - Fax:303-284-7668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-08
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health