Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 4301087299 | MI |
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | D71162 | MD |
NPI | 1053435198 |
---|---|
Provider Name | Dr. Tiffany Williams |
First Address | Kansas City, MO 64141-1851 |
Second Address | Kansas City, KS 66160-8500 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2007 |
Last Update Date | 23/07/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036688900 | (05) | MD |