Provider Demographics
NPI:1538229695
Name:KAREN A. WILLIAMS MD
Entity type:Organization
Organization Name:KAREN A. WILLIAMS MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:A
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:505-843-7131
Mailing Address - Street 1:883 LEAD AVE SE
Mailing Address - Street 2:STE A
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87102-3644
Mailing Address - Country:US
Mailing Address - Phone:505-843-7131
Mailing Address - Fax:505-246-9421
Practice Address - Street 1:883 LEAD AVE SE
Practice Address - Street 2:STE A
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-3644
Practice Address - Country:US
Practice Address - Phone:505-843-7131
Practice Address - Fax:505-246-9421
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM77-295207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM33886Medicaid
NM33886Medicaid
NMD36039Medicare UPIN