Provider Demographics
NPI:1417150194
Name:JOSEPH M. WILLIAMS, M.D.,P.C.
Entity Type:Organization
Organization Name:JOSEPH M. WILLIAMS, M.D.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:FRESOLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-853-2020
Mailing Address - Street 1:591 LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-1901
Mailing Address - Country:US
Mailing Address - Phone:508-853-2020
Mailing Address - Fax:508-459-5082
Practice Address - Street 1:591 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-1901
Practice Address - Country:US
Practice Address - Phone:508-853-2020
Practice Address - Fax:508-459-5082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-08
Last Update Date:2010-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA150862207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAM19008OtherBLUE CROSS BLUE SHIELD
MAPR39113830002OtherCIGNA CT GENERAL
MA3155862Medicaid
MA59344OtherCIGNA
MA150862OtherTUFTS
MA152191OtherHARVARD PILGRIM HEALTH
MA99429OtherFALLON COMM HEALTH
MA=========OtherUNITED HEALTH CARE
MA3155862Medicaid
MA152191OtherHARVARD PILGRIM HEALTH
0014857Medicare UPIN