Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 4871367-1205 | UT |
Y | 207XS0106X | Orthopaedic Hand Surgeon | 4871367-1205 | UT |
NPI | 1013184431 |
---|---|
Provider Name | Benjamin Williams |
First Address | Salt Lake City, UT 84102-1891 |
Second Address | Salt Lake City, UT 84102-1891 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2008 |
Last Update Date | 22/12/2015 |