MEDICARE: JEFFREY C WILLIAMS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	13583	MS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	640507572RP	OTHER	MS	AMERICAN ADMIN GROUP
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	1787631	OTHER	MS	UNITED HEALTHCARE

General Provider Information

NPI Number	:	1134239940
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY C WILLIAMS MD

Provider Business Mailing Address
First Line	:	118 COLLEGE DRIVE BOX 5066
Second Line	:
City	:	HATTIESBURG
State	:	MS
Zip	:	39406
Country	:	US
Telephone Number	:	601-266-5390
Fax Number	:	601-266-4205

Provider Business Practice Location Address
First Line	:	2899 WEST 4TH STREET
Second Line	:
City	:	HATTIESBURG
State	:	MS
Zip	:	39406
Country	:	US
Telephone Number	:	601-266-5390
Fax Number	:	601-266-4205

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	10/07/2024

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