Provider Demographics
NPI:1912772880
Name:WILLIAMS, JAMES PAUL
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:PAUL
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 1:210 WINDSOR GREENE DR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NC
Mailing Address - Zip Code:28110-6907
Mailing Address - Country:US
Mailing Address - Phone:910-709-9956
Mailing Address - Fax:
Practice Address - Street 1:315 E WILSON ST
Practice Address - Street 2:
Practice Address - City:WINGATE
Practice Address - State:NC
Practice Address - Zip Code:28174-9665
Practice Address - Country:US
Practice Address - Phone:910-709-9956
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-20
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLAT-61032255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
2000057193OtherBOARD OF CERTIFICATION FOR THE ATHLETIC TRAINER