Provider Demographics
NPI:1487684973
Name:WILLIAMS, KEITH PATRICK (MD)
Entity type:Individual
Prefix:DR
First Name:KEITH
Middle Name:PATRICK
Last Name:WILLIAMS
Suffix:
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 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4903
Mailing Address - Country:US
Mailing Address - Phone:570-271-6144
Mailing Address - Fax:570-271-6578
Practice Address - Street 1:100 N ACADEMY AVE
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:PA
Practice Address - Zip Code:17822-9340
Practice Address - Country:US
Practice Address - Phone:570-271-6144
Practice Address - Fax:570-271-6578
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08677200207VX0000X, 207VM0101X
PAMD460309207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
No207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP4260682OtherOXFORD
NJ3787649000OtherAMERIHEALTH
NJP00846749OtherRAILROAD MEDICARE
NJ3526821OtherCIGNA
NJ0231142Medicaid
NJ6398760OtherAETNA HMO
NJ0231142Medicaid
NJP4260682OtherOXFORD
NJP00846749OtherRAILROAD MEDICARE
NJ100202728202OtherAMERICHOICE
NJ3526821OtherCIGNA
NJ3787649000OtherAMERIHEALTH
NJ6398760OtherAETNA HMO
NJP4201871OtherOXFORD
NJ60066856OtherHORIZON NJ HEALTH
NJP00846749OtherRAILROAD MEDICARE