1780702217 NPI number — J. BARTON WILLIAMS M.D., P.A.

Table of content: (NPI 1780702217)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780702217 NPI number — J. BARTON WILLIAMS M.D., P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
J. BARTON WILLIAMS M.D., P.A.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1780702217
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/19/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
255 BAPTIST BLVD
Provider Second Line Business Mailing Address:
SUITE 305
Provider Business Mailing Address City Name:
COLUMBUS
Provider Business Mailing Address State Name:
MS
Provider Business Mailing Address Postal Code:
39705-2011
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
662-241-0050
Provider Business Mailing Address Fax Number:
662-241-7747

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
255 BAPTIST BLVD
Provider Second Line Business Practice Location Address:
SUITE 305
Provider Business Practice Location Address City Name:
COLUMBUS
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
39705-2011
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
662-241-0050
Provider Business Practice Location Address Fax Number:
662-241-7747
Provider Enumeration Date:
03/26/2007

Additional Information

Authorized Official

Authorized Official Last Name:
WILLIAMS
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
BARTON
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
662-241-0050

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  14872 , registered in the state of MS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0124293 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1780657056 . This is a "NPI INDIVIDUAL" identifier . This identifiers is of the category "OTHER".




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