Individual
DR. ROGER D. WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
5000 W NATIONAL AVE, ZABLOCKI VA MEDICAL CENTER, MILWAUKEE, WI 53295-0001
(414) 384-2000
Mailing address
5000 W NATIONAL AVE, ZABLOCKI VA MEDICAL CENTER, MILWAUKEE, WI 53295-0001
(414) 384-2000
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
3042
WI
103G00000X
Clinical Neuropsychologist
983P
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
133649719
—
AR
01
—
50874000010
QUALCHOICE
AR
01
—
5T814
BLUE CROSS
AR
01
—
983P
CHAMPUS
AR
01
—
990007081
RAILROAD MEDICARE
AR
Enumeration date
09/20/2006
Last updated
09/16/2013
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