Provider Demographics
NPI:1134148497
Name:WILLIAMS, JOSEPH CLARK (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:CLARK
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:14690 SPRING HILL DR
Mailing Address - Street 2:STE 305
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609-8102
Mailing Address - Country:US
Mailing Address - Phone:352-277-5348
Mailing Address - Fax:352-606-2857
Practice Address - Street 1:8172 CHAUCER DR
Practice Address - Street 2:
Practice Address - City:WEEKI WACHEE
Practice Address - State:FL
Practice Address - Zip Code:34607-2204
Practice Address - Country:US
Practice Address - Phone:352-686-8818
Practice Address - Fax:352-686-9856
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME40691204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL217924OtherAVMED
FL3063OtherWELLCARE
FL26084OtherBCBS
FL042199500Medicaid
FL7925681OtherAETNA
FLP00984631OtherRR MCR
FLD62025Medicare UPIN
FL042199500Medicaid