Provider Demographics
NPI:1609243427
Name:WILLIAMS, JEFFREY (RPH)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1513 LIVE OAK ST
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:NC
Mailing Address - Zip Code:28516-1518
Mailing Address - Country:US
Mailing Address - Phone:252-504-2800
Mailing Address - Fax:252-504-2805
Practice Address - Street 1:1513 LIVE OAK ST
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:NC
Practice Address - Zip Code:28516-1518
Practice Address - Country:US
Practice Address - Phone:252-504-2800
Practice Address - Fax:252-504-2805
Is Sole Proprietor?:No
Enumeration Date:2015-08-27
Last Update Date:2015-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15818183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist