Provider Demographics
NPI:1528086873
Name:WILLIAMS, BRIAN ALEXANDER (MD)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:ALEXANDER
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 936
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:KY
Mailing Address - Zip Code:40743-0936
Mailing Address - Country:US
Mailing Address - Phone:606-330-7818
Mailing Address - Fax:606-330-7825
Practice Address - Street 1:701 BOB O LINK DR STE 120
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-3760
Practice Address - Country:US
Practice Address - Phone:859-277-3737
Practice Address - Fax:859-277-3765
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2019-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY394722085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201011980Medicaid
KYP00924152OtherRAILROAD MEDICARE (LKO)
KY000000704223OtherANTHEM BLUE CROSS BLUE SHIELD
KY1183433OtherCIGNA - LKO
KY667296OtherSTERLING HEALTH - LKO
KY667296OtherSTERLING HEALTH
KY50031976OtherPASSPORT HEALTH PLAN
KYP00440327OtherRAILROAD MEDICARE
KY000000498681OtherCIGNA FKO PROV. #
KY64102882Medicaid
KY7576431OtherAETNA
KY000000498685OtherCIGNA DKO PROV. #
KYP00440327OtherRAILROAD MEDICARE
KY1183433OtherCIGNA - LKO
KYP400039093Medicare PIN
KY0786504Medicare PIN