# ROGER WILLIAMS MD PC

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

## Provider details

- **NPI number:** 1972783736
- **Authorized official:** ROGER T WILLIAMS MD (PRESIDENT)
- **Authorized official phone:** (928) 532-5838

## Contact information

- **Practice address:** 5448 WHITE MOUNTAIN BLVD, SUITE 270, LAKESIDE, AZ 85929-5739
- **Practice address phone:** (928) 532-5838
- **Practice address fax:** (928) 532-6670
- **Mailing address:** PO BOX 10, OVERGAARD, AZ 85933-0010
- **Mailing address phone:** (928) 535-6667
- **Mailing address fax:** (928) 535-5561

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 22260 | AZ | Yes |

## Other

- **Enumeration date:** 11/09/2007
- **Last updated:** 12/12/2008