Provider Demographics
NPI:1194823419
Name:WILLIAMS, JAMES LEE JR (OD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:LEE
Last Name:WILLIAMS
Suffix:JR
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:8406 ASHDALE CT
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23832-2416
Mailing Address - Country:US
Mailing Address - Phone:804-639-2641
Mailing Address - Fax:804-639-2641
Practice Address - Street 1:241 CHARLES H DIMMOCK PKWY
Practice Address - Street 2:SUITE #3
Practice Address - City:COLONIAL HEIGHTS
Practice Address - State:VA
Practice Address - Zip Code:23834-2915
Practice Address - Country:US
Practice Address - Phone:804-526-9661
Practice Address - Fax:804-526-7987
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2008-08-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0618000713152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA00V838C85Medicare ID - Type Unspecified
VAU40884Medicare UPIN