Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | 2000-312 | NM |
NPI | 1124110283 |
---|---|
Provider Name | Dr. Todd E Williams |
First Address | Farmington, NM 87499-5820 |
Second Address | Farmington, NM 87401-8991 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2006 |
Last Update Date | 12/02/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B7802 | (05) | NM |
H24196 | (02) | NM |