Provider Demographics
NPI:1932203676
Name:WILLIAMS FAMILY MEDICINE LLC
Entity type:Organization
Organization Name:WILLIAMS FAMILY MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:KIRK
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:II
Authorized Official - Credentials:MD
Authorized Official - Phone:602-243-6000
Mailing Address - Street 1:3210 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85017-4504
Mailing Address - Country:US
Mailing Address - Phone:602-243-6000
Mailing Address - Fax:602-323-5367
Practice Address - Street 1:3210 GRAND AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85017-4504
Practice Address - Country:US
Practice Address - Phone:602-243-6000
Practice Address - Fax:602-323-5367
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-12
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ205926Medicaid
AZ83992Medicare PIN