Provider Demographics
NPI:1295407179
Name:WILLIAMS, JOHN F (CO)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:F
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:CO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1465 WOODBURY AVE # 667
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-3210
Mailing Address - Country:US
Mailing Address - Phone:949-371-7443
Mailing Address - Fax:603-607-5001
Practice Address - Street 1:1465 WOODBURY AVE # 667
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-3210
Practice Address - Country:US
Practice Address - Phone:949-371-7443
Practice Address - Fax:603-607-5001
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-29
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
C53454222Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist