Williams, Jerry K

Williams, Jerry K is an sole proprietor health care provider with primary practice located at 2301 7Th St Suite B, Las Vegas NM 87701-4966. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology, which is considered as his primary health care specialty. Williams, Jerry K can be contacted via phone (505) 426-1200.

Contact Information

Primary practice address
2301 7Th St Suite B Las Vegas NM 87701-4966
Phone: (505) 426-1200
Fax: (505) 426-1202
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology 2084N0402X 94-167 New Mexico

Profile Details

NPI number 1710086749
LBN Legal business name Williams, Jerry K
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 22nd, 2006
Last updated Jul 9th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710086749 NPPES
New Mexico Other 201311184 TAX ID
New Mexico MEDICAID 23432 TAX ID
New Mexico Other 201047864 TAX ID
New Mexico Other 00NM009T07 TAX ID
New Mexico Other C100521093 TAX ID
New Mexico Other NM9999 TAX ID

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