Provider Demographics
NPI:1871603936
Name:WILLIAMS, GUY (DO)
Entity type:Individual
Prefix:DR
First Name:GUY
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5200 DODGE ST
Mailing Address - Street 2:ANESTHESIA DEPARTMENT
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-4113
Mailing Address - Country:US
Mailing Address - Phone:402-955-7986
Mailing Address - Fax:402-955-4300
Practice Address - Street 1:939 S 106TH PLZ
Practice Address - Street 2:SUITE 101
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-4782
Practice Address - Country:US
Practice Address - Phone:402-955-7986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO35079207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCL9778Medicare ID - Type UnspecifiedINDIVIDUAL NUMBER