Provider Demographics
NPI:1194777060
Name:WILLIAMS, JOSEPH H (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:H
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2855 E MAGIC VIEW DR
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-6245
Mailing Address - Country:US
Mailing Address - Phone:208-639-4900
Mailing Address - Fax:208-639-4901
Practice Address - Street 1:2855 E MAGIC VIEW DR
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-6245
Practice Address - Country:US
Practice Address - Phone:208-639-4900
Practice Address - Fax:208-639-4901
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5188-320208800000X
IN01094248A208800000X
IDM-7605208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID000010157308OtherBLUE SHIELD MERIDIAN
IDB5608OtherBLUE CROSS BOISE
ID76707OtherBLUE CROSS MERIDIAN
ID80521180Medicaid
ID000010137499OtherBLUE SHIELD BOISE
IDP00253274OtherRAILROAD MEDICARE
ID000010157308OtherBLUE SHIELD MERIDIAN
ID80521180Medicaid