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Individual

TERRY WILLIAMS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
200 E CHESTNUT ST, LOUISVILLE, KY 40202-1831
(502) 629-7601
Mailing address
234 E GRAY ST, SUITE 850, LOUISVILLE, KY 40202-1900
(502) 585-1735

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
27234
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000050038
BC BS
KY
01
000000308613
BC BS
KY
01
1051834
PASSPORT
KY
05
200022800A
IN
01
50005988
PASSPORT
KY
05
64272347
KY
05
6427234700
KY
Enumeration date
07/11/2005
Last updated
03/05/2008
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