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NPI Code Detail

MEDICARE: MR. JOSEPH WILLIAMS PA-C

MEDICARE:  MR. JOSEPH  WILLIAMS  PA-C
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
1363AM0700XMedical Physician Assistant5601002193MI

General Provider Information

NPI Number : 1700880200
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JOSEPH WILLIAMS PA-C
Provider Business Mailing Address
First Line : 3200 W CENTRE AVE
Second Line : STE. 203
City : PORTAGE
State : MI
Zip : 49024-4889
Country : US
Telephone Number : 269-324-0799
Fax Number : 269-324-8013
Provider Business Practice Location Address
First Line : 4613 W MAIN ST
Second Line : STE. B
City : KALAMAZOO
State : MI
Zip : 49006-2645
Country : US
Telephone Number : 269-343-8800
Fax Number : 269-343-9769
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2005
Last Update Date : 10/02/2009

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Directions to “ MR. JOSEPH WILLIAMS PA-C” Practice Location

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