Provider Demographics
NPI:1871565531
Name:WILLIAMS, LLOYD III (MD)
Entity type:Individual
Prefix:DR
First Name:LLOYD
Middle Name:
Last Name:WILLIAMS
Suffix:III
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 1:100 W HORTON ST
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:IN
Mailing Address - Zip Code:46714-3607
Mailing Address - Country:US
Mailing Address - Phone:260-824-0800
Mailing Address - Fax:260-824-7243
Practice Address - Street 1:201 E SOUTH ST
Practice Address - Street 2:
Practice Address - City:MARKLE
Practice Address - State:IN
Practice Address - Zip Code:46770-9068
Practice Address - Country:US
Practice Address - Phone:260-758-2156
Practice Address - Fax:260-824-7243
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01038604A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
INP00756728OtherRAILROAD MEDICARE
IN100351110Medicaid
INE17588Medicare UPIN
IN100351110Medicaid
IN370640IMedicare ID - Type Unspecified
INE17588Medicare UPIN