Provider Demographics
NPI:1396402087
Name:WILLIAMS, JOHN HENRY
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:HENRY
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6124 E FORSEE RD
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:MO
Mailing Address - Zip Code:65010-9296
Mailing Address - Country:US
Mailing Address - Phone:719-352-5055
Mailing Address - Fax:
Practice Address - Street 1:6124 E FORSEE RD
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:MO
Practice Address - Zip Code:65010-9296
Practice Address - Country:US
Practice Address - Phone:719-352-5055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-17
Last Update Date:2021-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program