Provider Demographics
NPI:1417079112
Name:WILLIAMS, JAMES THOMAS (PHYSICIAN ASST)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:THOMAS
Last Name:WILLIAMS
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Gender:M
Credentials:PHYSICIAN ASST
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Mailing Address - Street 1:4704 HOEN AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95405-7824
Mailing Address - Country:US
Mailing Address - Phone:707-546-7979
Mailing Address - Fax:707-546-7667
Practice Address - Street 1:728 MENDOCINO AVE
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95401-4804
Practice Address - Country:US
Practice Address - Phone:707-623-9803
Practice Address - Fax:707-843-3257
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2017-02-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAPA12244363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant