Organization
MARK WILLIAMS M.D., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK A. WILLIAMS M.D. (PRESIDENT)
(502) 244-9355
Entity
Organization
Contact information
Practice address
12010 SHELBYVILLE RD, SUITE 300, LOUISVILLE, KY 40243-1054
(502) 244-9355
(502) 244-9577
Mailing address
PO BOX 436256, LOUISVILLE, KY 40253-6256
(502) 244-9355
(502) 244-9577
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
34119
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000334878
ANTHEM PROVIDER ID
KY
01
—
5931697
AETNA PROVIDER ID
—
01
—
H10999
UPIN
KY
01
—
P00202037
RAILROAD MEDICARE ID
KY
Enumeration date
08/03/2006
Last updated
06/17/2024
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