Provider Demographics
NPI:1235149840
Name:WILLIAMS, JAMES S JR (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:S
Last Name:WILLIAMS
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 NORTHLINE CIRCLE
Mailing Address - Street 2:STE 100
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44119
Mailing Address - Country:US
Mailing Address - Phone:216-692-7832
Mailing Address - Fax:216-692-7802
Practice Address - Street 1:99 NORTHLINE CIRCLE
Practice Address - Street 2:STE 100
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44119
Practice Address - Country:US
Practice Address - Phone:216-692-7832
Practice Address - Fax:216-692-7802
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH069070207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0179364Medicaid
OHOR9923891Medicare ID - Type Unspecified
OH0179364Medicaid