Provider Demographics
NPI:1730367582
Name:J. BARTON WILLIAMS MD PA
Entity type:Organization
Organization Name:J. BARTON WILLIAMS MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:BARTON
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:662-241-0050
Mailing Address - Street 1:3491 BLUECUTT ROAD, SUITE 3
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:MS
Mailing Address - Zip Code:39705-1343
Mailing Address - Country:US
Mailing Address - Phone:662-244-0050
Mailing Address - Fax:662-241-7747
Practice Address - Street 1:3491 BLUECUTT ROAD, SUITE 2
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:MS
Practice Address - Zip Code:39705-1343
Practice Address - Country:US
Practice Address - Phone:662-244-0050
Practice Address - Fax:662-241-7747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-04
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS14872207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS0124293Medicaid
BW0348400OtherDEA
E72202Medicare UPIN
MS0124293Medicaid