Provider Demographics
NPI:1639177256
Name:WILLIAMS, JAMES ANDREW (DO)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:ANDREW
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3409 N HOLLAND SYLVANIA RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43615-1411
Mailing Address - Country:US
Mailing Address - Phone:419-843-8680
Mailing Address - Fax:419-841-3052
Practice Address - Street 1:3409 N HOLLAND SYLVANIA RD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-1411
Practice Address - Country:US
Practice Address - Phone:419-843-8680
Practice Address - Fax:419-841-3052
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-00-5346-W207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1972780021OtherGROUP NPI
OH0868691Medicaid
OH9293911OtherMEDICARE
OH1972780021OtherGROUP NPI
OH0868691Medicaid