Provider Demographics
NPI:1861647083
Name:WILLIAMS, JOHN L JR (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:L
Last Name:WILLIAMS
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:9377 E BELL RD
Mailing Address - Street 2:307
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-1502
Mailing Address - Country:US
Mailing Address - Phone:480-502-5755
Mailing Address - Fax:480-502-5736
Practice Address - Street 1:9377 E BELL RD
Practice Address - Street 2:307
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-1502
Practice Address - Country:US
Practice Address - Phone:480-502-5755
Practice Address - Fax:480-502-5736
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-02
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ27563208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery