Provider Demographics
NPI:1861523565
Name:WILLIAMS, NATHAN DWIGHT (MD)
Entity type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:DWIGHT
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 1:783 N 200 W
Mailing Address - Street 2:
Mailing Address - City:BOUNTIFUL
Mailing Address - State:UT
Mailing Address - Zip Code:84010-6905
Mailing Address - Country:US
Mailing Address - Phone:801-292-6696
Mailing Address - Fax:
Practice Address - Street 1:2830 S REDWOOD RD
Practice Address - Street 2:
Practice Address - City:WEST VALLEY CITY
Practice Address - State:UT
Practice Address - Zip Code:84119-5625
Practice Address - Country:US
Practice Address - Phone:801-975-3701
Practice Address - Fax:801-975-3711
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT159413-1205207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine