RONALD N. WILLIAMS PH.D.

Clinical Neuropsychologist

Fort Wayne, Indiana

Provider NPI: 1457358392

Provider Information:
 RONALD N. WILLIAMS PH.D.
Gender: M
Not Sole Proprietor

Practice Location:
11104 PARKVIEW CIRCLE DR STE 110 FORT WAYNE, IN 46845 US
Tel: 260-460-3203  Fax: 260-460-3130

Business Mailing Address:
11104 PARKVIEW CIRCLE DR STE 110 FORT WAYNE, IN 46845 US
Tel: 260-460-3203  Fax: 260-460-3130

Entity Type: Individual

Taxonomy:

Primary	Code	Category/Description	State	License Number
Y	103G00000X	Behavioral Health & Social Service Providers Clinical Neuropsychologist	IN	20040664A

Other Provider Identifiers:

Issuer	Number	State	Type
	0968903	OH	05
RR MEDICARE	860000042	IN	01
	200040240	IN	05

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin

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