Kevin Jon Williams, MD

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

MD043247E Issued in PA

Practice address

3401 N Broad St
Philadelphia, PA 19140-5103

Phone

(215) 707-4600

Fax

(215) 707-5599

NPI assigned

Jun 1, 2009

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1243814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463011200000",
    "number": "1013143437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 W HUNTING PARK AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191291302",
            "telephone_number": "215-707-4600",
            "fax_number": "215-707-5599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405103",
            "telephone_number": "215-707-4600",
            "fax_number": "215-707-5599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "KEVIN",
        "middle_name": "JON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-01",
        "last_updated": "2016-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "PA",
            "license": "MD043247E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1022944020001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelli Sue Williams, PHD
• Kelly Williams Elizabeth Williams, LCSW
• Kendal Williams, MD
• Kenneth V. Williams, D.O.
• Kevin Williams Jr.
• Khadijah Williams
• Khadir Williams
• Kim Laray Williams
• Kyle Alex Williams
• Kyra C Williams, MD

• Endocrinology, Diabetes & Metabolism Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Endocrinology, Diabetes & Metabolism Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.