Basic Information
| Provider Information | |||||||||
| NPI: | 1013654219 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WILLIAMS | ||||||||
| FirstName: | RICHARD | ||||||||
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| Credential: | ATC, OTC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1130 | ||||||||
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| City: | FRISCO | ||||||||
| State: | CO | ||||||||
| PostalCode: | 804431130 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9702627400 | ||||||||
| FaxNumber: | 9702627401 | ||||||||
| Practice Location | |||||||||
| Address1: | 68 SCHOOL RD | ||||||||
| Address2: | STE 100 | ||||||||
| City: | FRISCO | ||||||||
| State: | CO | ||||||||
| PostalCode: | 80443 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9702627400 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/18/2022 | ||||||||
| LastUpdateDate: | 05/18/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/03/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | SA.0002236 | CO | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.