MEDICARE: DR. JAMES LEE WILLIAMS JR. O.D.

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	152W00000X	Optometrist	0618000713	VA

General Provider Information

NPI Number	:	1194823419
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES LEE WILLIAMS JR. O.D.

Provider Business Mailing Address
First Line	:	8406 ASHDALE CT
Second Line	:
City	:	CHESTERFIELD
State	:	VA
Zip	:	23832-2416
Country	:	US
Telephone Number	:	804-639-2641
Fax Number	:	804-639-2641

Provider Business Practice Location Address
First Line	:	241 CHARLES H DIMMOCK PKWY
Second Line	:	SUITE #3
City	:	COLONIAL HEIGHTS
State	:	VA
Zip	:	23834-2915
Country	:	US
Telephone Number	:	804-526-9661
Fax Number	:	804-526-7987

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

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	08/20/2008

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