Provider Demographics
NPI:1548309131
Name:WILLIAMS, JAMES B JR (PA-C)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:B
Last Name:WILLIAMS
Suffix:JR
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:904 W ARTHUR ST
Mailing Address - Street 2:
Mailing Address - City:HUGO
Mailing Address - State:OK
Mailing Address - Zip Code:74743-2271
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1970 E WHIPPOORWILL LN
Practice Address - Street 2:
Practice Address - City:ATOKA
Practice Address - State:OK
Practice Address - Zip Code:74525-8415
Practice Address - Country:US
Practice Address - Phone:580-889-6651
Practice Address - Fax:580-889-9163
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OKPA401363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKPA00401Medicare UPIN