Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 2005033056 | MO |
NPI | 1043290620 |
---|---|
Provider Name | Dr. James L Williams II |
First Address | Chesterfield, MO 63017-3509 |
Second Address | Chesterfield, MO 63017-3509 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2006 |
Last Update Date | 12/04/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
202424901 | (05) | MO |
H35630 | (02) | MO |
P00324188 | MEDICARE,RAIL ROAD (01) |