Roger Williams MD PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

22260 Issued in AZ

Legal business name

ROGER WILLIAMS MD PC

Practice address

5448 White Mountain Blvd
Suite 270
Lakeside, AZ 85929-5739

Phone

(928) 532-5838

Fax

(928) 532-6670

NPI assigned

Nov 9, 2007

Last updated

Dec 12, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Roger T Williams, MDNPI 1487631842

Title

President

Phone

(928) 532-5838

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Roger T Williams, MD

  • General Practice Physician
  • Show Low, AZ
  • NPI 1487631842

  Family Medicine

  NPD (past) Authorized official

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

{
    "created_epoch": "1194566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229040000000",
    "number": "1972783736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10",
            "city": "OVERGAARD",
            "state": "AZ",
            "postal_code": "859330010",
            "telephone_number": "928-535-6667",
            "fax_number": "928-535-5561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5448 WHITE MOUNTAIN BLVD",
            "address_2": "SUITE 270",
            "city": "LAKESIDE",
            "state": "AZ",
            "postal_code": "859295739",
            "telephone_number": "928-532-5838",
            "fax_number": "928-532-6670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROGER WILLIAMS MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-09",
        "last_updated": "2008-12-12",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "928-532-5838",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "22260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Lakeside, AZ
• Providers in Lakeside, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2008; 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.