| Organization Name: | WILLIAMS MEDICAL GROUP, P.C. |
| NPI Number: | 1558311969 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JEFFREY MARCUS WILMOTH (SECRETARY-TREASURER) |
| Mailing Address: | 111 N Taylor Ave Suite A Kirkwood |
| State: | MO US |
| Postal Code: | 631224358 |
| Phone Number: | 3148229997 |
| Fax Number: | 3148229994 |
| NPI Enumeration Date: | 05/10/2006 |
| NPI Last Update Date: | 03/23/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 2657039-0 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |