Individual
DR. FRED O. WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
23500 US HIGHWAY 160, WALSENBURG, CO 81089-9524
(719) 738-5100
Mailing address
23500 US HIGHWAY 160, WALSENBURG, CO 81089-9524
(719) 738-5100
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
17644
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01176445
—
CO
01
—
930095240
RR MEDICARE
CO
Enumeration date
01/24/2006
Last updated
08/19/2016
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