Provider Demographics
NPI:1184654790
Name:WILLIAMS, BENJAMIN JAMES (MED, ATC)
Entity Type:Individual
Prefix:MR
First Name:BENJAMIN
Middle Name:JAMES
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MED, ATC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:1401 BENJAMIN PKWY
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-4518
Mailing Address - Country:US
Mailing Address - Phone:336-544-3905
Mailing Address - Fax:336-544-3936
Practice Address - Street 1:1401 BENJAMIN PKWY
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-4518
Practice Address - Country:US
Practice Address - Phone:336-544-3905
Practice Address - Fax:336-544-3936
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC02872255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer