Provider Demographics
NPI:1891796561
Name:WILLIAMS, PAUL F (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:F
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:612 COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28540-5311
Mailing Address - Country:US
Mailing Address - Phone:910-347-2154
Mailing Address - Fax:910-347-3165
Practice Address - Street 1:612 COLLEGE ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28540-5311
Practice Address - Country:US
Practice Address - Phone:910-347-2154
Practice Address - Fax:910-347-3165
Is Sole Proprietor?:No
Enumeration Date:2005-08-03
Last Update Date:2015-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC19299207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8987891Medicaid
NC211581BOtherMEDICARE ID
87891OtherBCBS
NC211581BOtherMEDICARE ID