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1780661074

NPI Code Detail

MEDICARE: DR. JEFFREY WILLIAMS DO

MEDICARE: DR. JEFFREY WILLIAMS DO

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	207Q00000X	Family Medicine Physician	02002139A	IN
2	207Q00000X	Family Medicine Physician	34006949W	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	CA1586	OTHER		GROUP MEDICARE RAILROAD
6	080157683	OTHER		MEDICARE RAILROAD

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
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	0110615	OTHER		UHC PIN
5	000000185151	OTHER		ANTHEM PIN
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	311413469041	OTHER		CARESOURCE PIN
9	000000177576	OTHER		UNISON PIN
10	000000873283	OTHER	IN	ANTHEM PROVIDER NUMBER

General Provider Information

NPI Number	:	1780661074
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY WILLIAMS DO

Provider Business Mailing Address
First Line	:	250 N SHADELAND AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46219-4959
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1500 SALEM ST
Second Line	:
City	:	LAFAYETTE
State	:	IN
Zip	:	47904-2164
Country	:	US
Telephone Number	:	765-448-8000
Fax Number	:

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

Provider Enumeration Date	:	12/28/2005
Last Update Date	:	06/03/2026

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Directions to “ DR. JEFFREY WILLIAMS DO” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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