Basic Information
| Provider Information | |||||||||
| NPI: | 1548282841 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WILLIAMS | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | C. | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | O.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 123 OCRACOKE LN | ||||||||
| Address2: | |||||||||
| City: | HILTON HEAD ISLAND | ||||||||
| State: | SC | ||||||||
| PostalCode: | 299263515 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8105169231 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 7800 RIVERS AVE | ||||||||
| Address2: | |||||||||
| City: | N CHARLESTON | ||||||||
| State: | SC | ||||||||
| PostalCode: | 294064057 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8435723404 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/24/2006 | ||||||||
| LastUpdateDate: | 01/08/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 4901002603 | MI | N | Eye and Vision Services Providers | Optometrist | 152W00000X | 1691 | SC | Y | Eye and Vision Services Providers | Optometrist | 152W00000X | OPT002682 | GA | N | Eye and Vision Services Providers | Optometrist |
No ID Information.