Healthcare Provider Details

I. General information

NPI: 1093085276
Provider Name (Legal Business Name): JOSHUA S WILLIAMS PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2012
Last Update Date: 03/29/2023
Certification Date: 03/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

617 E RIVERSIDE DR STE 301
ST GEORGE UT
84790-8722
US

IV. Provider business mailing address

617 E RIVERSIDE DR STE 301
ST GEORGE UT
84790-8722
US

V. Phone/Fax

Practice location:
  • Phone: 435-216-7000
  • Fax: 435-216-7001
Mailing address:
  • Phone: 435-216-7000
  • Fax: 435-216-7001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number8185027-1206
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number8185027-1206
License Number StateUT
# 3
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number8185027-1202
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: