Provider Demographics
NPI:1538330923
Name:WILLIAMS, JOSEPH J (MD PC)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:J
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MD PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5401 OLD YORK RD
Mailing Address - Street 2:KLEIN PROF BLDG STE 403
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19141-3030
Mailing Address - Country:US
Mailing Address - Phone:215-457-0700
Mailing Address - Fax:215-457-0419
Practice Address - Street 1:5401 OLD YORK RD
Practice Address - Street 2:KLEIN PROF BLDG STE 403
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19141-3030
Practice Address - Country:US
Practice Address - Phone:215-457-0700
Practice Address - Fax:215-457-0419
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-13
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD023619E208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2426697000OtherBLUE CROSS
PA000872587Medicaid
PA1761018OtherBLUE SHIELD
07096OtherHEALTH PARTNERS
PA1153698OtherKEYSTONE MERCY
PA104534OtherBLUE CROSS
PA2362644OtherAETNA
PA104534OtherBLUE SHIELD
PA0053486000OtherBLUE CROSS
C30135Medicare UPIN
07096OtherHEALTH PARTNERS