Provider Demographics
NPI:1548282841
Name:WILLIAMS, JAMES C (OD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:C
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 OCRACOKE LN
Mailing Address - Street 2:
Mailing Address - City:HILTON HEAD ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29926-3515
Mailing Address - Country:US
Mailing Address - Phone:810-516-9231
Mailing Address - Fax:
Practice Address - Street 1:7800 RIVERS AVE
Practice Address - Street 2:
Practice Address - City:N CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-4057
Practice Address - Country:US
Practice Address - Phone:843-572-3404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901002603152W00000X
SC1691152W00000X
GAOPT002682152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIU37186Medicare UPIN
MI0Z96509Medicare PIN