| Dr David Williams, DO | |
|
490 Centre Lake Dr Ne, Suite 200, Palm Bay, FL 32907-1113 | |
| (800) 476-8646 | |
| (919) 382-3210 |
| Full Name | Dr David Williams |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Location | 490 Centre Lake Dr Ne, Palm Bay, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760484034 | NPI | - | NPPES |
| 57352 | Other | FL | BCBS GROUP # 34457 |
| 379858500 | Medicaid | FL | |
| 57352 | Other | FL | BCBS GROUP # 45368 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | OS6588 (Florida) | Primary |
| Entity Name | Medfast Urgent Care Centers Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1285735605 PECOS PAC ID: 1052418837 Enrollment ID: O20070514000442 |
| Entity Name | Melbourne Emergency Group, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1932562915 PECOS PAC ID: 2860783925 Enrollment ID: O20160620002409 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr David Williams, DO 725 S Tropical Trl, Merritt Island, FL 32952-4952 Ph: (321) 751-7222 | Dr David Williams, DO 490 Centre Lake Dr Ne, Suite 200, Palm Bay, FL 32907-1113 Ph: (800) 476-8646 |
John Koehler, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 1840 Eldron Blvd Se Ste 1, Palm Bay, FL 32909 Phone: 321-312-4580 Fax: 321-914-4053 | |
Anthony Tucker, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 1840 Eldron Blvd Se Ste 1, Palm Bay, FL 32909 Phone: 321-312-4580 Fax: 321-914-4053 |