Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | ME40691 | FL |
NPI | 1134148497 |
---|---|
Provider Name | Dr. Joseph Clark Williams |
First Address | Spring Hill, FL 34609-8102 |
Second Address | Weeki Wachee, FL 34607-2204 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2006 |
Last Update Date | 04/09/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
042199500 | (05) | FL |
217924 | AVMED (01) | FL |
26084 | BCBS (01) | FL |
3063 | WELLCARE (01) | FL |
7925681 | AETNA (01) | FL |
P00984631 | RR MCR (01) | FL |