# MOAB FAMILY MEDICINE PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528070489
- **Authorized official:** DR. KENNETH LEWIS WILLIAMS MD (OWNER/PHYSICIAN/PARTNER)
- **Authorized official phone:** (435) 259-7121

## Contact information

- **Practice address:** 476 WILLIAMS WAY, A, MOAB, UT 84532-2065
- **Practice address phone:** (435) 259-7121
- **Practice address fax:** (435) 259-3112
- **Mailing address:** 476 WILLIAMS WAY STE A, PO BOX 1270, MOAB, UT 84532-2065
- **Mailing address phone:** (435) 259-7121
- **Mailing address fax:** (435) 259-3112

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | UT | Yes |

## Other

- **Enumeration date:** 08/12/2006
- **Last updated:** 05/20/2016