Provider Demographics
NPI:1770550386
Name:WILLIAMS, JAMES A (DDSPA)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:A
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:DDSPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:619 N 1ST ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:JACKSONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72076-4117
Mailing Address - Country:US
Mailing Address - Phone:501-982-5384
Mailing Address - Fax:501-982-0697
Practice Address - Street 1:619 N 1ST ST
Practice Address - Street 2:SUITE A
Practice Address - City:JACKSONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72076-4117
Practice Address - Country:US
Practice Address - Phone:501-982-5384
Practice Address - Fax:501-982-0697
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2662122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist