1023421500 NPI number — JAMIESE MORGAN WILLIAMS M.D.

Table of content: JAMIESE MORGAN WILLIAMS M.D. (NPI 1023421500)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023421500 NPI number — JAMIESE MORGAN WILLIAMS M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WILLIAMS
Provider First Name:
JAMIESE
Provider Middle Name:
MORGAN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1023421500
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
777 GLADES RD., BC 71, FLORIDA ATLANTIC UNIVERSITY
Provider Second Line Business Mailing Address:
INTERNAL MEDICINE RESIDENCY PROGRAM, COLLEGE OF MEDICIN
Provider Business Mailing Address City Name:
BOCA RATON
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33431
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
561-955-5365
Provider Business Mailing Address Fax Number:
561-955-3577

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6060 N FOUNTAIN PLAZA DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TUCSON
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85704-7870
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
520-229-2578
Provider Business Practice Location Address Fax Number:
520-229-2561
Provider Enumeration Date:
06/03/2014

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  54594 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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