Provider Demographics
NPI:1639062656
Name:WILLIAMS, GABRIEL M (DC)
Entity type:Individual
Prefix:
First Name:GABRIEL
Middle Name:M
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1199 W LEXINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:KY
Mailing Address - Zip Code:40391-1134
Mailing Address - Country:US
Mailing Address - Phone:859-737-5800
Mailing Address - Fax:859-737-5801
Practice Address - Street 1:1199 W LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:KY
Practice Address - Zip Code:40391-1134
Practice Address - Country:US
Practice Address - Phone:859-737-5800
Practice Address - Fax:859-737-5801
Is Sole Proprietor?:No
Enumeration Date:2025-05-29
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYPENDING111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor