Individual
MR. KENNETH EARL WILLIAMS I
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
1501 SAN PEDRO DR SE, ALBUQUERQUE, NM 87108-5153
(505) 256-5746
(505) 256-5772
Mailing address
1501 SAN PEDRO DR SE, ALBUQUERQUE, NM 87108-5153
(505) 256-5746
(505) 256-5772
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
80-PA018
NM
Other
Enumeration date
08/31/2006
Last updated
07/08/2007
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