Individual
JOHN W WILLIAMS IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 E PRIMROSE ST, STE 400, SPRINGFIELD, MO 65807-5154
(417) 875-3000
Mailing address
PO BOX 9007, SPRINGFIELD, MO 65808-9007
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
35263
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
006013294
MEDICARE PTAN
MO
05
—
200114909
—
MO
01
—
6336
BLUE CROSS/BLUE SHIELD
—
Enumeration date
06/16/2006
Last updated
02/06/2013
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