Provider Demographics
NPI:1376121293
Name:WILLIAMS, JHAMIGKHA
Entity Type:Individual
Prefix:
First Name:JHAMIGKHA
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 LOGAN RD
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MS
Mailing Address - Zip Code:39336-6232
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:730 LOGAN RD
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MS
Practice Address - Zip Code:39336-6232
Practice Address - Country:US
Practice Address - Phone:601-357-0773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-31
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor