Provider Demographics
NPI:1922105592
Name:WILLIAMS, JOYCE ANN (DO)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:ANN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4160 HOLIDAY ST NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-2532
Mailing Address - Country:US
Mailing Address - Phone:330-492-1747
Mailing Address - Fax:
Practice Address - Street 1:4160 HOLIDAY ST NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-2532
Practice Address - Country:US
Practice Address - Phone:330-492-1747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-17
Last Update Date:2012-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT10810207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0146336Medicaid
MT000099938OtherBCBS OF MT
I38681Medicare UPIN
MT000084848Medicare ID - Type Unspecified