Individual
DR. RYAN DALE WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9702 STONESTREET RD STE 100, LOUISVILLE, KY 40272-6809
(502) 588-0610
(502) 588-0611
Mailing address
PO BOX 776879, CHICAGO, IL 60677-6879
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
54090
KY
208000000X
Pediatrics Physician
R4544
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
138516
OREGON EMERGENCY MEDICAL SERVICES PROVIDER LICENSE NUMBER
OR
Enumeration date
08/15/2013
Last updated
10/29/2020
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