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DR. JONATHAN SCOTT WILLIAMS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1329 LAZAR PL, FLORENCE, SC 29501-5664
(843) 629-9516
Mailing address
PO BOX 23321, NEW YORK, NY 10087-3321

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
20176
SC
2085R0204X
Vascular & Interventional Radiology Physician
20176
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0530Q
BCBS OF NC
SC
01
154758900
US DEPT OF LABOR
SC
05
201766
SC
01
300090699
RAILROAD MEDICARE
SC
01
570525838
STANDARD TAX ID
SC
01
790530Q
NC MEDICAID
NC
01
81364
MEDCOST
SC
Enumeration date
09/30/2005
Last updated
10/16/2025
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