Provider Demographics
NPI:1336155837
Name:WILLIAMS, JAMES A (DC)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:A
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1485 N SHOOP AVE
Mailing Address - Street 2:
Mailing Address - City:WAUSEON
Mailing Address - State:OH
Mailing Address - Zip Code:43567
Mailing Address - Country:US
Mailing Address - Phone:419-335-2225
Mailing Address - Fax:603-908-5670
Practice Address - Street 1:1485 N SHOOP AVE
Practice Address - Street 2:
Practice Address - City:WAUSEON
Practice Address - State:OH
Practice Address - Zip Code:43567
Practice Address - Country:US
Practice Address - Phone:419-335-2225
Practice Address - Fax:603-908-5670
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2010-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1656111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0799284Medicaid
U27110Medicare UPIN
OH0799284Medicaid