Healthcare Provider Details

I. General information

NPI: 1639177256
Provider Name (Legal Business Name): JAMES ANDREW WILLIAMS DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2005
Last Update Date: 09/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3409 N HOLLAND SYLVANIA RD
TOLEDO OH
43615-1411
US

IV. Provider business mailing address

3409 N HOLLAND SYLVANIA RD
TOLEDO OH
43615-1411
US

V. Phone/Fax

Practice location:
  • Phone: 419-843-8680
  • Fax: 419-841-3052
Mailing address:
  • Phone: 419-843-8680
  • Fax: 419-841-3052

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number34-00-5346-W
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: