Basic Information
| Provider Information | |||||||||
| NPI: | 1366702441 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WILLIAMS | ||||||||
| FirstName: | LUKE | ||||||||
| MiddleName: | CARTER | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6775 CROSSWINDS DR N | ||||||||
| Address2: | |||||||||
| City: | ST PETERSBURG | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337105471 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7273818006 | ||||||||
| FaxNumber: | 7273819629 | ||||||||
| Practice Location | |||||||||
| Address1: | 6775 CROSSWINDS DR N | ||||||||
| Address2: | |||||||||
| City: | ST PETERSBURG | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337105471 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7273818006 | ||||||||
| FaxNumber: | 7273819629 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/22/2012 | ||||||||
| LastUpdateDate: | 11/23/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/23/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 005439 | GA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | ME121232 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.