Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | LL39790 | SC |
Y | 208600000X | Surgeon | LL39790 | SC |
NPI | 1003267246 |
---|---|
Provider Name | Dr. Barton Wade Williams |
First Address | Spartanburg, SC 29303 |
Second Address | Spartanburg, SC 29303-3040 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2016 |
Last Update Date | 29/06/2016 |