Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207SG0201X | Clinical Genetics (M.D.) | 56966-20 | WI |
Y | 208000000X | Pediatrician | 56966-20 | WI |
NPI | 1811216716 |
---|---|
Provider Name | Katie B Williams |
First Address | Viroqua, WI 54665-2059 |
Second Address | Viroqua, WI 54665-2059 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2010 |
Last Update Date | 13/07/2020 |