Provider Demographics
NPI:1306107628
Name:WILLIAMS, JOHN AUSTIN
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:AUSTIN
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:335 W 1ST ST
Mailing Address - Street 2:
Mailing Address - City:OSWEGO
Mailing Address - State:NY
Mailing Address - Zip Code:13126-3655
Mailing Address - Country:US
Mailing Address - Phone:315-343-3344
Mailing Address - Fax:877-522-7977
Practice Address - Street 1:335 W 1ST ST
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:NY
Practice Address - Zip Code:13126-3655
Practice Address - Country:US
Practice Address - Phone:315-343-3344
Practice Address - Fax:877-522-7977
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-04
Last Update Date:2012-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health