Provider Demographics
NPI:1366461691
Name:WILLIAMS, ERNEST (DC)
Entity Type:Individual
Prefix:DR
First Name:ERNEST
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 W COHAWKIN RD STE C
Mailing Address - Street 2:
Mailing Address - City:CLARKSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08020-1145
Mailing Address - Country:US
Mailing Address - Phone:856-423-7700
Mailing Address - Fax:856-423-0823
Practice Address - Street 1:810 MANTUA BLVD
Practice Address - Street 2:
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-1344
Practice Address - Country:US
Practice Address - Phone:856-464-2300
Practice Address - Fax:856-468-6446
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC04400111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0278185000OtherAMERIHEALTH PROVIDER
PA0278185000OtherIBC PROVIDER NUMBER