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Individual

ROGER T WILLIAMS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1500 S WHITE MOUNTAIN RD BLDG 3, SHOW LOW, AZ 85901-7111
(284) 325-8389
Mailing address
PO BOX 10, OVERGAARD, AZ 85933-0010
(928) 532-5838
(801) 423-3309

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
22260
AZ
208D00000X
General Practice Physician
Primary
22260
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
173758
AZ
Enumeration date
12/28/2005
Last updated
06/19/2024
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