Provider Demographics
NPI:1073534491
Name:WILLIAMS, JOSEPH LAWSON (DO)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:LAWSON
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23366 FARMINGTON RD
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:48336-3102
Mailing Address - Country:US
Mailing Address - Phone:248-476-3333
Mailing Address - Fax:248-476-7123
Practice Address - Street 1:23366 FARMINGTON RD
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:MI
Practice Address - Zip Code:48336-3102
Practice Address - Country:US
Practice Address - Phone:248-476-3333
Practice Address - Fax:248-476-7123
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2009-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101-011913207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIG14906Medicare UPIN
MIP10590001Medicare PIN