Provider Demographics
NPI:1366709602
Name:WILLIAMS, JOSEPH (DO)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10562 FOREST HILL DR
Mailing Address - Street 2:
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-7389
Mailing Address - Country:US
Mailing Address - Phone:724-316-6009
Mailing Address - Fax:
Practice Address - Street 1:250 DEBARTOLO PL
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44512-7004
Practice Address - Country:US
Practice Address - Phone:330-314-9100
Practice Address - Fax:330-758-3282
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-11
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OH34012810207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0222384Medicaid