Individual
BRUCE R WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1509 NW MOCK AVE, BLUE SPRINGS, MO 64015-3096
(816) 229-8187
(816) 229-1181
Mailing address
1509 NW MOCK AVE, BLUE SPRINGS, MO 64015-3096
(816) 229-8187
(816) 229-1181
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO R9H16
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100452270A
—
KS
05
—
242574432
—
MO
Enumeration date
09/20/2005
Last updated
12/21/2009
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