Individual
TIMOTHY R WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2200 STATE ST, LAWRENCEVILLE, IL 62439-1852
(618) 943-7242
Mailing address
2200 WEST STATE ST., LAWRENCEVILLE, IL 62439
(618) 943-7242
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
036.120252
IL
207P00000X
Emergency Medicine Physician
Primary
02001015A
IN
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
02001015AB
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
245815311
—
MO
Enumeration date
07/12/2005
Last updated
03/23/2016
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