Organization
GENERAL VASCULAR SURGERY SPECIALIST P A
Active
Other names
Steven C Williams MD
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN CHARLES WILLIAMS MD (PRESIDENT)
(601) 684-2481
Entity
Organization
Contact information
Practice address
1311 ASTON AVENUE, MCCOMB, MS 39648-2825
(601) 684-2481
(601) 684-2488
Mailing address
1311 ASTON AVE, MCCOMB, MS 39648-2825
(601) 684-2481
(601) 684-2488
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
09423
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00115579
—
MS
01
—
0055406
MISSISSIPPI SELECT
MS
01
—
0200000153
INDIVIDUAL MEDICARE PTAN
MS
01
—
1317934
LOUISIANA MEDICAID
LA
01
—
1730019
UNITED HEALTHCARE
MS
01
—
412909978A
BLUECROSS BLUESHIELD
MS
01
—
770000345
RAILROAD MEDICARE
MS
Enumeration date
09/11/2006
Last updated
01/13/2014
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