Provider Demographics
NPI:1316922750
Name:WILLIAMS, LLEWELYN ANTHONY (MD)
Entity type:Individual
Prefix:DR
First Name:LLEWELYN
Middle Name:ANTHONY
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2170 E LOHMAN AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88001-8411
Mailing Address - Country:US
Mailing Address - Phone:575-449-7002
Mailing Address - Fax:575-652-4684
Practice Address - Street 1:2170 E LOHMAN AVE
Practice Address - Street 2:SUITE C
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88001-8411
Practice Address - Country:US
Practice Address - Phone:575-449-7002
Practice Address - Fax:575-652-4684
Is Sole Proprietor?:No
Enumeration Date:2005-12-08
Last Update Date:2014-11-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NMMD2010-0116207LP2900X
PAMD059713L207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAG72986Medicare UPIN
028375QJ1Medicare ID - Type Unspecified