Provider Demographics
NPI:1609967843
Name:WILLIAMS, JOHN WILEY JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:WILEY
Last Name:WILLIAMS
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:411 W CHAPEL HILL ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27701-3616
Mailing Address - Country:US
Mailing Address - Phone:919-668-2134
Mailing Address - Fax:
Practice Address - Street 1:508 FULTON ST
Practice Address - Street 2:AMBULATORY CARE, DURHAM VAMC
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-3875
Practice Address - Country:US
Practice Address - Phone:919-286-6936
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2014-07-24
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Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC32910207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine