Provider Demographics
NPI:1942412887
Name:WILLIAMS, STEVEN C (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:C
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:PO BOX 746
Mailing Address - Street 2:
Mailing Address - City:MCCOMB
Mailing Address - State:MS
Mailing Address - Zip Code:39649-0746
Mailing Address - Country:US
Mailing Address - Phone:601-684-2481
Mailing Address - Fax:601-684-2488
Practice Address - Street 1:1311 ASTON AVE
Practice Address - Street 2:
Practice Address - City:MCCOMB
Practice Address - State:MS
Practice Address - Zip Code:39648-2825
Practice Address - Country:US
Practice Address - Phone:601-684-2481
Practice Address - Fax:601-684-2488
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS09423208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00115579Medicaid
MS1730019OtherUNITED HEALTHCARE
LA1317934Medicaid
MS770000345OtherRAILROAD MEDICARE
MS0055406OtherMISSISSIPPI SELECT
MS020000153Medicare ID - Type Unspecified
D80609Medicare UPIN