Individual
JEFFREY W WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-7021
Mailing address
PO BOX 602658, CHARLOTTE, NC 28260-2658
(336) 716-2255
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
0010-03582
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8102606
—
NC
Enumeration date
06/18/2012
Last updated
05/05/2014
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