Provider Demographics
NPI:1629589213
Name:JEFFREY A WILLIAMS, OD, PC
Entity Type:Organization
Organization Name:JEFFREY A WILLIAMS, OD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:251-538-7015
Mailing Address - Street 1:510 N INGLESIDE ST
Mailing Address - Street 2:
Mailing Address - City:FAIRHOPE
Mailing Address - State:AL
Mailing Address - Zip Code:36532-3013
Mailing Address - Country:US
Mailing Address - Phone:251-538-7015
Mailing Address - Fax:251-968-5923
Practice Address - Street 1:170 E FORT MORGAN RD
Practice Address - Street 2:
Practice Address - City:GULF SHORES
Practice Address - State:AL
Practice Address - Zip Code:36542-3510
Practice Address - Country:US
Practice Address - Phone:251-968-5917
Practice Address - Fax:251-968-5923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-23
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS751-TA324152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty