DR. JERRY K WILLIAMS JR. (NPI# 1710086749) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710086749 |
| Entity Type | Individual |
| Full Name | DR. JERRY K WILLIAMS JR. |
| Credential | M.D. |
| Practice Address |
2301 7th St Suite B Las Vegas NM 87701-4966 |
| Mailing Address |
Po Box 3861 Las Vegas NM 87701-6861 |
| Practice Telephone | 5054261200 |
| Practice Fax Number | 5054261202 |
| Mailing Telephone | 5054261200 |
| Mailing Fax Number | 5054261202 |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0402X |
Psychiatry & Neurology Specialization: Neurology with Special Qualifications in Child Neurology |
94-167 | NM | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | PHP & SALUD | 201047864 | 01 |
| NM | 23432 | 05 | |
| NM | MUTUAL OF OMAHA | NM9999 | 01 |
| NM | BCBS | 00NM009T07 | 01 |
| NM | TAX ID | 201311184 | 01 |
| NM | UNITED AMERICAN | C100521093 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881164762 | Jerry B Williams | Dentist | 24121 Ne 124th Circle, Brush Prairie, WA 98606-4322 | 2018-12-04 |
| 1447317722 | Jerry Valentine Williams | Internal Medicine | 317 W Ascension St, Gonzales, LA 70737-2805 | 2007-01-03 |
| 1962516195 | Jerry Lee Williams | Dentist | 310 N Tennessee St, Suite E, Cartersville, GA 30120-3270 | 2006-08-17 |
| 1053308114 | Jerry W Williams | Optometrist | 1605 W Court St, Winnfield, LA 71483-2653 | 2005-10-04 |
| 1073035168 | Jerry D Williams II | Nurse Practitioner | 340 Stateline Rd W, Southaven, MS 38671 | 2017-07-11 |
| 1538618145 | Jerry Williams | Nurse Practitioner | 1340 Broad Ave Ste 300, Gulfport, MS 39501-2404 | 2016-09-23 |
| 1326398249 | Jerry Williams | Counselor | 1302 Calle De La Merced, Espanola, NM 87532-2624 | 2012-09-18 |
| 1184877698 | Jerry Roy Williams | Counselor | 1255 Hilyard St, Eugene, OR 97401-3718 | 2008-10-28 |
| 1174791727 | Jerry Gregory Williams | Counselor | 2814 Lancaster Ave, Wilmington, DE 19805-5225 | 2008-02-18 |
| 1902028087 | Jerry Lee Williams | Counselor | 4041 Marlton Ave, Suite 136, Los Angeles, CA 90008-2519 | 2007-05-02 |
| Street Address |
2301 7TH ST SUITE B |
| City | LAS VEGAS |
| State | NM |
| Zip Code | 87701-4966 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306830450 | San Miguel Clinic Corp Dba Northern New Mexico Urology | Urology | 2301 7th St, Las Vegas, NM 87701-4966 | 2005-09-06 |
| 1447752951 | Chris Sixto Manzanares | Counselor | 2301 7th St, Las Vegas, NM 87701-4966 | 2018-03-01 |
| 1578012506 | Bernadette Montoya | Counselor | 2301 7th St, Las Vegas, NM 87701-4966 | 2016-10-03 |
| 1942625744 | Lincare Inc | Durable Medical Equipment & Medical Supplies | 2301 7th St, Suite B, Las Vegas, NM 87701-4966 | 2014-03-03 |
| 1992140305 | Rio Grande Alcoholism Treatment Program | Community/Behavioral Health | 2301 7th St, Las Vegas, NM 87701-4966 | 2013-04-30 |
| 1003250572 | Maria L Vigil | Counselor | 2301 7th St, Las Vegas, NM 87701-4966 | 2013-04-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851884423 | Nueva Vida Counseling and Consulting Services LLC | Community/Behavioral Health | Nueva Vida Counseling & Consulting Services LLC, 1920 7th Street, Las Vegas, NM 87701 | 2018-06-08 |
| 1316475403 | El Centro Family Health | Family Medicine | 475 Legion Dr., Las Vegas, NM 87701 | 2017-06-01 |
| 1700327384 | Anastacia Sena Jaramillo | Psychologist | 126 Silva Ave., Las Vegas, NM 87701 | 2017-03-15 |
| 1013369222 | Home Medical Equipment Specialists,llc | Durable Medical Equipment & Medical Supplies | 514 8th Street, Las Vegas, NM 87701 | 2016-07-12 |
| 1750730826 | John Michael Tourangeau | Social Worker | 1920 7th Street, Las Vegas, NM 87701 | 2016-06-08 |
| 1154705689 | Lindsy Laura Kragt Allen | Podiatrist | 1608 7th St, Las Vegas, NM 87701 | 2015-07-14 |
| 1023409521 | Ambercare Medical Supply | Durable Medical Equipment & Medical Supplies | 1747 N Grand Ave, Las Vegas, NM 87701 | 2015-02-05 |
| 1538561964 | El Centro Family Health | Clinic/Center | 947 Old National Road, Las Vegas, NM 87701 | 2014-09-17 |
| 1164832150 | Plaza Drugs | Pharmacist | 178 Bridge St, Las Vegas, NM 87701 | 2014-04-30 |
| 1043648165 | Open Doors Home Health Care | Home Health | 713 Railroad Ave., Las Vegas, NM 87701 | 2013-10-29 |
| Find all providers in zip 87701 | ||||
| Taxonomy Code | 2084N0402X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology with Special Qualifications in Child Neurology |
| A Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295397297 | Jefferson Family Corporation, Inc | Psychiatry & Neurology | 304 S. Jones Blvd, Suite #3673, Las Vegas, NV 89107 | 2019-07-01 |
| 1275748493 | Rooman Ahad | Psychiatry & Neurology | 630 S Rancho Dr Ste A, Las Vegas, NV 89106-4849 | 2007-05-11 |
| 1588797146 | University of Nv School of Medicine Multi Specialty Group Practice So | Psychiatry & Neurology | 1707 W Charleston Blvd, 220, Las Vegas, NV 89102-2351 | 2007-03-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407275456 | Danny Rogers | Psychiatry & Neurology | 900 Camino De Salud, Albuquerque, NM 87131-0001 | 2014-04-07 |
| 1538401518 | Kathy Marie Wolfe | Psychiatry & Neurology | Msc 10 5590, 1 University of New Mexico, Albuquerque, NM 87131-0001 | 2013-03-18 |
| 1184630832 | Mary Ida Johnson | Psychiatry & Neurology | 2nd Ambulatory Care Ctr, 2211 Lomas Blvd. Ne, Albuquerque, NM 87131-0001 | 2006-08-01 |
| 1174539662 | Jennifer Vickers | Psychiatry & Neurology | 2nd Ambulatory Care Ctr, 2211 Lomas Blvd. Ne, Albuquerque, NM 87131-0001 | 2006-08-01 |
| 1235145848 | Russell Snyder | Psychiatry & Neurology | 2nd Ambulatory Care Ctr, 2211 Lomas Blvd. Ne, Albuquerque, NM 87131-0001 | 2006-08-01 |
| 1558376020 | Leslie Morrison | Psychiatry & Neurology | 2nd Ambulatory Care Ctr, 2211 Lomas Blvd. Ne, Albuquerque, NM 87131-0001 | 2006-07-30 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.