Provider Demographics
NPI:1194018689
Name:WILLIAMS, JUSTIN ALLEN (DO)
Entity type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:ALLEN
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:ROCKCASTLE REGIONAL HOSPITAL
Mailing Address - Street 2:145 NEWCOMB AVE.
Mailing Address - City:MT. VERNON
Mailing Address - State:KY
Mailing Address - Zip Code:40456
Mailing Address - Country:US
Mailing Address - Phone:606-256-7798
Mailing Address - Fax:
Practice Address - Street 1:145 NEWCOMB AVE
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:KY
Practice Address - Zip Code:40456
Practice Address - Country:US
Practice Address - Phone:606-256-7798
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-17
Last Update Date:2019-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR2674207R00000X
KY03718207RH0003X
390200000X390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program