Provider Demographics
NPI:1710607221
Name:JON S. WILLIAMS, PLLC.
Entity Type:Organization
Organization Name:JON S. WILLIAMS, PLLC.
Other - Org Name:SLIM VEGAS BARIATRIC & GENERAL SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/SURGEON
Authorized Official - Prefix:
Authorized Official - First Name:JON
Authorized Official - Middle Name:S
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-329-0229
Mailing Address - Street 1:6030 S RAINBOW BLVD STE D2
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89118-2548
Mailing Address - Country:US
Mailing Address - Phone:702-329-0229
Mailing Address - Fax:866-611-3024
Practice Address - Street 1:6030 S RAINBOW BLVD STE D2
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89118-2548
Practice Address - Country:US
Practice Address - Phone:702-329-0229
Practice Address - Fax:866-611-3024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-02
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV75520OtherPTAN
NV19934OtherMEDICAL LICENSE
NV1316385529Medicaid
NV1992064323Medicaid