Provider Demographics
NPI:1699339101
Name:WILLIAMS, BRUCE E III (PA)
Entity type:Individual
Prefix:MR
First Name:BRUCE
Middle Name:E
Last Name:WILLIAMS
Suffix:III
Gender:M
Credentials:PA
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 9007
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22906-9007
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:16268 BENNETT RD
Practice Address - Street 2:
Practice Address - City:CULPEPER
Practice Address - State:VA
Practice Address - Zip Code:22701-4630
Practice Address - Country:US
Practice Address - Phone:540-825-6263
Practice Address - Fax:540-825-4911
Is Sole Proprietor?:No
Enumeration Date:2019-04-30
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0110007013207Q00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine