Provider Demographics
NPI:1093850257
Name:WILLIAMS, THOMAS FRANKLIN JR (PHD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:FRANKLIN
Last Name:WILLIAMS
Suffix:JR
Gender:M
Credentials:PHD
Other - Prefix:
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Mailing Address - Street 1:1895 KINGSLEY AVE
Mailing Address - Street 2:S-1005
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32073
Mailing Address - Country:US
Mailing Address - Phone:904-298-2525
Mailing Address - Fax:904-298-1515
Practice Address - Street 1:1542 KINGSLEY AVE
Practice Address - Street 2:S-141
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-4586
Practice Address - Country:US
Practice Address - Phone:904-278-9828
Practice Address - Fax:904-278-9818
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2011-12-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLFLAY1067231H00000X
FLAY1067231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003911700Medicaid
FLCY149Medicare UPIN