Healthcare Provider Details

I. General information

NPI: 1144452293
Provider Name (Legal Business Name): JAMES FRAZIER WILLIAMS D.M.D., M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2009
Last Update Date: 04/25/2025
Certification Date: 04/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1403 SOUTH MADISON ST
TUPELO MS
38801
US

IV. Provider business mailing address

2500 N STATE ST
JACKSON MS
39216-4500
US

V. Phone/Fax

Practice location:
  • Phone: 601-984-6185
  • Fax:
Mailing address:
  • Phone: 601-984-6185
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number3506-09
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: