Individual
DR. JEREMY SCOTT WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 GARTON PLZ, WESTON, WV 26452-2128
(304) 517-1301
(304) 517-1304
Mailing address
1 GARTON PLZ, WESTON, WV 26452-2128
(304) 517-1301
(304) 517-1304
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
23084
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810015258
—
WV
01
—
WI7400611
MEDICARE PTAN
—
Enumeration date
05/09/2007
Last updated
07/11/2012
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