MEDICARE: MR. THOMAS JOHN WILLIAMS PA-C

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	363AM0700X	Medical Physician Assistant	257	MA

General Provider Information

NPI Number	:	1801824396
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. THOMAS JOHN WILLIAMS PA-C

Provider Business Mailing Address
First Line	:	4 BRUCE RD
Second Line	:	-
City	:	HOLBROOK
State	:	MA
Zip	:	02343-1263
Country	:	US
Telephone Number	:	781-767-2428
Fax Number	:

Provider Business Practice Location Address
First Line	:	4 BRUCE RD
Second Line	:	-
City	:	HOLBROOK
State	:	MA
Zip	:	02343-1263
Country	:	US
Telephone Number	:	781-767-2428
Fax Number	:

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

Provider Enumeration Date	:	06/30/2006
Last Update Date	:	07/08/2007

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