| Mark Williams M.d., Llc | |
|
12010 Shelbyville Rd Suite 300 Louisville KY 40243-1054 | |
| (502) 244-9355 | |
| (502) 244-9577 |
| Full Name | Mark Williams M.d., Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 12010 Shelbyville Rd, Louisville, Kentucky |
| Authorized Official Name and Position | Mark A. Williams (PRESIDENT) |
| Authorized Official Contact | 5022449355 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark Williams M.d., Llc Po Box 436256 Louisville KY 40253-6256 Ph: (502) 244-9355 | Mark Williams M.d., Llc 12010 Shelbyville Rd Suite 300 Louisville KY 40243-1054 Ph: (502) 244-9355 |
| NPI Number | 1821006032 |
|---|---|
| Provider Enumeration Date | 08/03/2006 |
| Last Update Date | 06/17/2024 |
| Medicare PECOS PAC ID | 6406815794 |
|---|---|
| Medicare Enrollment ID | O20041004000215 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821006032 | NPI | - | NPPES |
| 000000334878 | Other | KY | ANTHEM PROVIDER ID |
| 5931697 | Other | AETNA PROVIDER ID | |
| P00202037 | Other | KY | RAILROAD MEDICARE ID |
| H10999 | Other | KY | UPIN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 34119 (Kentucky) | Primary |
| Provider Name | Mark Anthony Williams |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710179585 PECOS PAC ID: 1850369976 Enrollment ID: I20040917000045 |
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