Provider Demographics
NPI:1902214638
Name:WILLIAMS, JAMES
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:USS WHIRLWIND
Mailing Address - Street 2:PC 11
Mailing Address - City:FPO
Mailing Address - State:AE
Mailing Address - Zip Code:09591-1970
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:USS WHIRLWIND
Practice Address - Street 2:PC 11
Practice Address - City:FPO
Practice Address - State:AE
Practice Address - Zip Code:09591-1970
Practice Address - Country:US
Practice Address - Phone:301-401-2854
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-25
Last Update Date:2014-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman